孤立性肺炎性结节的CT诊断

Solitary lung inflammatory nodule:CT findings

目的 :研究孤立性肺炎性结节的CT表现 ,提高对该病的正确诊断率。方法 :选择接受CT检查的孤立性肺炎性结节 6 0例 ,2 7例抗炎治疗后病灶消失 ,15例经皮肺穿刺活检证实 ,18例手术证实。结果 :①病灶部位 :两下叶 6 0 % ,上叶 2 3.3% ,中叶 10 %。②CT征象 :形状不规则 5 3.3% ,圆形或类圆形 4 6 .7% ;病灶边缘模糊 4 5 % ,部分清楚、部分模糊16 7% ,边界清楚 38.3% ;密度均匀 5 8.3% ,密度不均匀 4 1.7% ;与胸膜广泛粘连 5 0 % ,条状或线状粘连 11.7% ,无胸膜改变 38.3%。③经抗炎治疗证实的 2 7例 ,15例治疗 1～ 3周病灶吸收 ,12例治疗 1个多月才吸收。结论 :病灶边界模糊 ,形状不规则且长轴与肺段的走行一致 ,与胸膜广泛粘连对孤立性肺炎性结节的诊断很有价值 ,结节边界清楚应考虑到炎性假瘤 ;各种征象的综合分析对诊断很有帮助 ,在同一层面上 ,若纵隔窗较肺窗明显缩小多见于炎性结节。

Objective:To study CT findings of solitary lung inflammatory nodule and to improve CT diagnostic accuracy.Methods:CT findings of 60 cases with solitary lung inflammatory nodules were analyzed. Twenty-seven cases were treated with antibiotics, fifteen cases were diagnosed by the percutaneous transthoracic needle biopsy, eighteen cases were treated with surgery.Results:①Location,60% in lower lobe,23.3% in upper lobe, 10% in middle lobe.② CT findings:Irregular nodule (53.3%),spherical nodule or nodule similar to sphere (46.7%);nodule with blurred margin(45%),part of margin well-defined(16.7%),nodule with homogeneous density (58.3%),nodule with heterogeneous density(41.7%);nodule with widely plueral conglutination (50%),nodule with striped or linear plueral conglutination (41.7%), nodule without plueral reaction (38.3%).③ Dynamic change:among the cases with the treatment with antibiotics, nodules were resolved in 1～3 weeks (15 cases), nodules were resolved after one month(12 cases).5'HZConclusion:The CT findings of irregular nodule with blurred margin, long axis consistent with lung segment and with widely plueral conglutination play an important role in diagnosis of solitary lung inflammatory nodule,nodule with well-defined margin should be considered to be inflammatory pseudotumor. The combining analyses of various imaging findings is very helpful to diagnosis, at the same cross-section scan, the size of the nodule at lung window is smaller than at mediastinal window is in favor of solitary inflammatory lung nodule.