慢性肺段肺炎的CT诊断

CT diagnosis of the chronic pneumonia of pulmonary segment

目的分析慢性肺段肺炎的CT特点及诊断价值。方法搜集22例慢性肺段肺炎。全部经穿刺、手术病理,或临床随访证实。重点观察病灶的外形、边缘、密度、支气管和邻近改变。结果大多数肺段病灶均有2,3个以上的CT层面呈楔形或锥状(尖朝向肺门,底部位于肺外周),少数病灶需将各个层面叠加起来方呈锥形外观。慢性肺段肺炎病灶边缘多稍内凹或平直,楔尖支气管通畅,未见结节;密度较均匀,可见支气管气像或支扩;底部相邻胸膜增厚明显。诊断符合率75%。结论慢性肺段肺炎CT表现有一定特点,诊断时须综合分析各种征象。不典型病例的诊断有赖于病理。

Objective: To analyze the CT features of the chronic pneumonia of the pulmonary segment. Methods: The CT findings of 22 patients with chronic pneumonia of the segment were reviewed, all proved pathologically or clinically. Results: 2,3 wedge-shape or cone-shape of lesions was demonstrated in most of cases. The border of lesion was depression or straight without hilar mass and bronchus obstructed. Most lesion was isodensity and the air bronchogram could be found in some cases. 75% of the cases was diagnosed correctly. Conclusions: Some relative specific CT manifestation exists in the chronic pneumonia of the pulmonary segment. But CT of some cases is similar to that caused by tuberculosis and lung cancer, of which diagnosis must be based on pathology.