CT诊断单发肺结核空洞与癌性空洞的价值观察

Diagnostic Value of CT for Single Tuberculosis Cavity and Cancerous Cavity

目的观察CT诊断单发肺结核空洞和癌性空洞的应用价值。方法回顾性分析2017年6月至2019年4月咸宁市结核病防治院经病理与临床证实的50例单发肺结核性空洞患者、48例肺癌性空洞患者的临床资料,均行CT检查,对比其影像学表现。结果肺结核性空洞主要表现为厚壁且厚度均匀,周围有卫星灶,癌性空洞多表现为薄壁,内缘凹凸不平,可见壁结节,分叶与胸膜凹陷征;肺癌性空洞者空洞部位为肺下叶、空洞呈偏心性、分叶征、胸膜凹陷征、毛刺征、壁结节、薄壁空洞、胸膜牵拉比例高于单发肺结核性空洞(P<0.05),而周围卫星灶、钙化率低于单发肺结核性空洞(P<0.05),两组空洞平均直径、壁CT强化幅度比较差异无统计学意义(P>0.05)。结论CT诊断肺结核空洞与癌性空洞均有一定价值,可依据空洞部位、分叶征、胸膜凹陷征、毛刺征、壁厚度、胸膜牵拉、卫星灶等征象对两者进行鉴别。

Objective To observe the application value of CT in the diagnosis of single tuberculosis cavity and cancerous cavity.Methods The clinical data of 50 patients with a single tuberculosis cavity and 48 patients with cancerous cavity confirmed by pathology and clinic in Xianning Tuberculosis Prevention and Control Hospital,Hubei,during the period from June 2017 to April 2019 were retrospectively analyzed.All patients underwent CT.Their imaging findings we re compared.Results Tuberculosis cavity was characterized by a thick wall and uniform thickness.There were satellite lesions around.The cancerous cavity was mostly characterized by thin wall,uneven inner edge.And there were wall nodules,lobulation sign pleural indentation sign.The proportions of the cavity located at inferior lobe lung,cavity showing eccentricity type,lobulation sign,pleural indentation sign,burr sign,wall nodules,thin-wall cavity,pleural traction in cancerous cavity patients were higher than those of single tuberculosis cavity patients(P<0.05),while surrounding satellite lesions and calcification rate were lower than those in single tuberculosis cavity patients(P<0.05).There was no significant difference in the mean diameter of the cavity or wall CT enhancement amplitude between the two groups(P>0.05).Condusion There is a certain diagnostic value of CT for both tuberculosis cavity and cancerous cavity.They can be differentiated according to the signs of cavity sites,lobulation sign,pleural indentation sign,burr sign,wall thickness,pleu ral tra ction and satellite lesions.