螺旋CT在继发性肺结核与肺癌鉴别诊断中的价值

摘要

目的:分析继发性肺结核与肺癌的螺旋CT影像特点,总结螺旋CT在其鉴别诊断中的应用价值.方法:回顾分析经病理及临床证实100例继发性肺结核及20例肺癌的影像学特征,评价其影像表现差异.结果:100例肺结核中,结核球12例,其中直径2.0-3.0cm圆形、椭圆形、孤立性结节影8例,直径＞3.0cm,出现分叶、毛刺、空泡、胸膜凹陷等征象的不典型结核瘤4例,易误诊为肺癌;空洞36例,呈圆形或类圆形,薄壁空洞22例,厚壁空洞14例;合并支气管内膜结核20例,合并胸腔积液15例,合并纵隔、肺门淋巴结核17例.20例肺癌,肺内肿块14例,12例外壁呈分叶状,8例有放射状短毛刺,3例偏心性空洞,肺门肿块6例,有4例合并肺结核.结论:螺旋CT在继发性肺结核与肺癌鉴别中具有重要价值.%Objective : To analyze the spiral CT imaging characteristics of secondary tuberculosis and lung cancer,and differential diagnosis value of spiral CT. Methods : The CT characteristics of 100 cases of secondary tuberculosis and 20 cases of lung cancer confirmed by pathology and clinical were retrospectively analyzed. Results : Of the 100 secondary tuberculosis cases, there were tuberculosis tumor 12 cases, diameter of 2. 0 to 3. 0 cm circle , elliptic , isolation of nodules 8 cases , ＞ 3. 0 cm in diameter , appear points leaves , hurr, empty buhble , pleural sag etc signs of not typical of tuberculosis tumor 4 cases,easily misdiagnosed as lung cancer. Empty 36 cases were round or kind of circular , thin wall empty 22 cases , thick wall empty 14 cases ; merger bronchial lining tuberculosis 20 cases , merger pleural effusion 15 cases , merger mediastinum ,lung door scrofulous 17 cases. Of 20 lung cancer cases, there were lung tumor 14 cases,12 exception wall was the lobulated, radial short burr 8 cases , eccentric empty 3 cases , hilar tumor 6 cases,have 4 cases amalgamative tuberculosis. Conclusion: Spiral CT in secondary tuberculosis and lung cancer has important value to differential diagnosis.