线样环形强化征在脓肿及原发性伴囊变坏死性肿瘤中的鉴别价值

Differentiating value of the sign of linear circular enhancement on abscess and primary necrotic tumor

目的:探讨线样环形强化征在脓肿及原发性伴囊变坏死性肿瘤中的鉴别价值。方法:回顾性分析2016年1月至2018年10月经手术、病理或临床治疗随访证实的脓肿及原发性伴囊变坏死性肿瘤的CT影像学资料112例及相关病理图片93例,统计线样环形强化征在2种病变中的出现率,采用卡方检验分析是否具有统计学意义。结果:73例脓肿和39例原发性伴囊变坏死性肿瘤中,出现线样环形强化征者分别为65例(89.0%)和2例(5.1%),在8例脓肿误诊病例中,7例(87.5%)有本征象出现,而在3例原发性伴囊变坏死性肿瘤病变误诊病例中均未出现本征象,线样环形强化征在2种病变的出现率具有统计学差异(P<0.05)。此外,病理图片示脓肿坏死区边缘存在丰富的炎性肉芽组织,包绕坏死区分布,内含较多新生毛细血管;而原发性伴囊变坏死性肿瘤内坏死区边缘为肿瘤细胞,滋养血管极少,且排列杂乱。结论:线样环形强化征为炎性肉芽组织在增强CT上的表现,可作为脓肿及原发性伴囊变坏死性肿瘤的一个影像学鉴别指标。

Objective:To explore the differentiating value of linear circular enhancement on abscess and primary necrotic tumor.Methods:CT imaging data of 112 patients and relevant pathological images of 93 patients with abscess and primary necrotic tumor confirmed by pathology,operation or clinical following-up from January 2016 to October 2018 were retrospectively analyzed. Occurrences of linear circular enhancement in two kinds of diseases were counted and the result was analyzed by using the chi-square test. Results:Among 73 patients with abscess and 39 patients with primary necrotic tumor,65 and 2 had linear circular enhancement,with percentage of 89.0% and 5.1%,respectively. Among 8 patients with misdiagnosed abscess,7(87.5%)had this sign,while 3 misdiagnosed cases of primary necrotic tumor had no sign,with significant differences between abscess and primary necrotic tumor(P<0.05). Furthermore,pathological images showed that major inflammatory granulation tissue wrapped around the necrotic area in abscess,containing many capillaries;the edge of necrosis area in tumor was tumor cells,disorderly and few nourishing vessels. Conclusion:Manifestation of linear circular enhancement as inflammatory granulation tissue in enhanced CT images can an iconographical differentiating index for both abscess and primary necrotic tumor.