孤立性肺空洞疾病影像学特征及临床诊断价值分析

Analysis of imaging features and clinical diagnostic value of solitary pulmonary cavity disease

目的分析孤立性肺空洞疾病影像学特征及临床诊断价值。方法选取2017年2月至2019年2月在本院接受治疗的108例孤立性肺空洞疾病患者为研究对象。选取的患者均经手术病理或穿刺活检证实为孤立性肺空洞疾病。108例孤立性肺空洞疾病患者中,有肺结核空洞41例,肺脓肿空洞22例,肺癌空洞31例,肺霉菌空洞2例,坏死性肺炎空洞12例。患者全部进行平扫,部分增强扫描。根据病理类型将患者进行分组,分析并比较各组患者的一般资料、影像学特征及临床资料变化情况。结果肺癌空洞患者平均发病年龄最大,肺结核空洞患者平均发病年龄最小,肺脓肿空洞、肺霉菌空洞及坏死性肺炎空洞患者平均发病年龄居中,差异有统计学意义(P<0.05);肺癌空洞患者中偏心空洞占(80.6%),空洞壁CT强化幅度为(24±9.87)Hu,与其它各组比较,差异均有统计学意义(P<0.05);肺结核空洞分布在双肺上叶的患者为(78.0%),与其它各组比较,差异有统计学意义(P<0.05);坏死性肺炎空洞患者气-液平面占(91.7%),与其它各组比较,差异均有统计学意义(P<0.05);肺霉菌空洞患者空洞内出现结节球比例为(100%),与其它各组比较,差异均有统计学意义(P<0.05);肺脓肿空洞患者肺空洞平均直径为(51.36±7.28)mm、空洞内壁光整比例为(90.9%),与其它各组比较,差异均有统计学意义(P<0.05);肺脓肿空洞及肺癌空洞患者空洞壁厚度明显高于其余各组,差异有统计学意义(P<0.05)。结论年龄在判断孤立性肺空洞疾病患者病变性质时具有提示作用;孤立性肺空洞疾病患者病变发生的部位、大小、空洞有无偏心、空洞内壁光整率、空洞壁厚度、气-液平面对病变的定性诊断具有较大的意义。

Objective Analyze the imaging characteristics and clinical diagnostic value of solitary pulmonary cavity disease.Methods A total of 108 patients with solitary pulmonary cavity disease who were treated in our hospital from February 2017 to February 2019 were selected as the research objects.The selected patients were confirmed to have solitary pulmonary cavity disease by surgical pathology or needle biopsy.Among 108 patients with solitary pulmonary cavity disease,41 had tuberculosis cavity,22 had lung abscess cavity,31 had lung cancer cavity,2 had pulmonary mold cavity,and 12 had necrotizing pneumonia cavity.All patients underwent plain scans and some enhanced scans.The patients were grouped according to the pathological type,and the general data,imaging characteristics and clinical data changes of each group of patients were analyzed and compared.Results The average age of onset of patients with lung cancer cavity was the oldest,the average age of patients with pulmonary tuberculosis cavity was the smallest,and the average age of onset of patients with lung abscess cavity,pulmonary fungal cavity and necrotizing pneumonia cavity was in the middle(P<0.05);among patients with lung cancer cavity was eccentric Cavities accounted for(80.6%),and the CT enhancement amplitude of the cavity wall was(24±9.87)Hu,Compared with other groups,the difference was statistically significant(P<0.05);patients with tuberculosis cavities distributed in the upper lobes of both lungs were(78.0%),compared with other groups(P<0.05);patients with necrotizing pneumonia cavity accounted for(91.7%),compared with other groups,the difference was statistically significant(P<0.05);The proportion of nodule balls in the cavities of patients with pulmonary mold cavities was(100%),which was statistically different compared with other groups(P<0.05);the average diameter of lung cavities in patients with pulmonary abscess cavities was(51.36)±7.28)mm,the ratio of smoothing the inner wall of the cavity was(90.9%),compared with other groups(P<0.05);the thickness of the cavity wall in patients with lung abscess and lung cancer cavity was significantly higher than the other groups(P<0.05).Conclusion Age has a prompting role in judging the nature of the disease in patients with solitary pulmonary cavity disease;the location of the disease in patients with solitary pulmonary cavity disease,the size,whether the cavity is eccentric,the smoothing rate of the cavity wall,the thickness of the cavity wall,and the gas-liquid plane on the disease The qualitative diagnosis is of great significance.