CAJ | 학술논문

目的探讨慢性肺炎、肺结核和肺癌引起的肺段楔形病变的多层螺旋CT(MSCT)特点及诊断价值.方法收集88例肺段病变的MSCT资料(30例慢性肺炎、24例肺结核、34例肺癌).全部经病理、痰检结核菌证实.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或经多平面重组技术(MPR)重建方呈锥形外观.慢性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,可见支气管气相或支气管扩张;底部相邻胸膜增厚明显.结核病灶边缘常不规则或模糊;密度不均;楔尖未见结节,可有支气管狭窄;卫星病灶和胸膜增厚较多见.肺癌病灶边缘可见外凸;密度均匀或较均匀;楔尖支气管阻塞和结节.诊断正确率82%.结论三种肺段病变MSCT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.
목적 탐토만성폐염、폐결핵화폐암인기적폐단설형병변적다층라선CT(MSCT)특점급진단개치.방법 수집88례폐단병변적MSCT자료(30례만성폐염、24례폐결핵、34례폐암).전부경병리、담검결핵균증실.중점관찰병조적외형、변연、밀도、지기관화린근개변.결과 대다수폐단병조균유2～3개이상적CT층면정설형혹추상(첨조향폐문,저부위우폐외주),소수병조수장각개층면첩가기래혹경다평면중조기술(MPR)중건방정추형외관.만성폐염병조변연다초내요혹평직,설첨지기관통창,미견결절;밀도교균균,가견지기관기상혹지기관확장;저부상린흉막증후명현.결핵병조변연상불규칙혹모호;밀도불균;설첨미견결절,가유지기관협착;위성병조화흉막증후교다견.폐암병조변연가견외철;밀도균균혹교균균;설첨지기관조새화결절.진단정학솔82%.결론 삼충폐단병변MSCT표현유일정특점,진단시수종합분석각충정상.불전형병례적진단유뢰우병리.
Objective To analyze CT features of the pulmonary segment lesions.Methods The CT findings of 88 patients with pulmonary segment lesions were reviewed.The diseases included chronic pneumonitis(n=30),tuberculosis(n=24),lung cancer(n=34),all proved pathologically.Results Wedge-shape or cone-shape of lesions was demonstrated in most of cases.In chronic pneumonitis,the border of lesion was depression or straight without hilar mass and bronchus obstructed.Most lesion was isodensity and the air bronehogram could be found in some cases.In tuberculosis,the border was irregular or hazy with different density inside the lesion(cavity,calcification,bronchieetasis).Satellite-lesion and thickening of the pleura nearby were found commonly.In lung cancer,the hilar mass and pot obstructed bronchus were the characteristic,with the border evagination in some cases.According to the above,82% of the cases were diagnosed correctly.Conclusions Some relative specific CT manifestation existed in the pulmonary segment lesions caused by chronic pneumonitis,tuberculosis and lung cancer.But the CT of some patients were similar to each other,of which diagnosis must be based on pathology.