MDCT诊断薄壁空洞性肺结核和薄壁囊腔型肺癌的临床价值探析

Clinical Value of MDCT in Diagnosis of Thin-walled Cavitary Tuberculosis and Thin-walled Cystic Lung Cancer

目的观察多层螺旋计算机断层成像(multidetector computed tomography,MDCT)诊断薄壁空洞性肺结核和薄壁囊腔型肺癌的临床应用价值。方法选取我院收治的32例薄壁空洞性肺结核患者(肺结核组)与25例薄壁囊腔型肺癌患者(肺癌组)资料进行回顾性分析,其中肺癌经病理学结果证实,肺结核经病理学结果或者痰涂片检查确诊,比较2组临床一般资料、CT定量分析及MDCT征象。结果肺癌组年龄明显高于肺结核组(P<0.05),含气腔隙壁厚明显小于肺结核组(P<0.05);2组形态分型比较差异显著(P<0.05),肺癌组形态分型大部分为Ⅳ型,肺结核组大部分为Ⅲ型;肺癌组蜂窝征、磨玻璃征、分叶征、短毛刺征、瘤肺界面清楚毛糙、含气腔隙数为多囊、内壁不光整、内部结构(分隔、壁结节、血管穿行)、血管集束征、胸膜凹陷征比例明显高于肺结核组(P<0.05);肺结核组长毛刺征、尖角征、含气腔隙数为单囊、内壁光整、卫星灶比例明显高于肺癌组(P<0.05)。结论 MDCT诊断薄壁空洞性肺结核和薄壁囊腔型肺癌呈现不同征象,蜂窝征、磨玻璃征、分叶征、短毛刺征、血管集束征、胸膜凹陷征、长毛刺征、尖角征、瘤肺界面、含气腔隙数、内壁光整度、卫星灶的差别分析有助于两者的诊断。

Objective To observe the clinical application value of multi-detector computed tomography(MDCT) in diagnosis of thin-walled cavitary tuberculosis and thin-walled cystic lung cancer. Methods A retrospective analysis was performed on the data of 32 patients with thin-walled cavitary tuberculosis(tuberculosis group) and 25 patients with thin-walled cystic lung cancer(lung cancer group). The lung cancer was confirmed by pathological results. The tuberculosis was confirmed by pathological results or sputum smear examination. The clinical general data, CT quantitative analysis and MDCT signs were compared between the two groups. Results The age of lung cancer group was significantly higher than that of tuberculosis group(P<0.05), while thickness of aircontaining lacunar wall was significantly smaller than that of tuberculosis group(P<0.05). There were significant differences in morphological classification between the two groups(P<0.05). Morphological classification of lung cancer group was mainly on type Ⅳ, while classification of tuberculosis group was mainly on type Ⅲ. The proportion of honeycomb sign, ground glass sign, lobulated sign, short burr sign, clear and rough tumor lung interface, polycystic air-containing lacunar, unsmooth inner wall, internal structure(separation, wall nodules, vascular trajection), vascular convergence sign and pleural indentation sign in lung cancer group was significantly higher than that in tuberculosis group(P<0.05). The proportion of long burr sign, sharp corner sign, unicapsular aircontaining lacunar, smooth inner wall and satellite lesions in tuberculosis group was significantly higher than that in lung cancer group(P<0.05). Conclusion There are different signs when MDCT diagnosing thin-walled cavitary tuberculosis and thinwalled cystic lung cancer. The differential analysis on honeycomb sign, ground glass sign, lobulated sign, short burr sign, vascular convergence sign, pleural indentation sign, long burr sign, sharp corner sign, tumor lung interface, air-containing lacunar, inner wall smoothness and the satellite lesions helps the diagnosis for both of them.