CAJ | 학술논문

目的：提高肺癌空洞形成的CT诊断与鉴别诊断水平。方法搜集经临床、实验室及手术确诊的37例肺癌空洞及的资料完整，及其它良性空洞与空腔性病变34例的CT图像进行回顾性分析。结果肺癌空洞主要CT表现有：厚壁偏心性空洞，可有壁结节，内壁凹凸不平可有分叶征、毛刺征、胸膜凹陷征等恶性肿瘤征象增强扫描空洞壁中等至明显强化；结核性空洞壁薄、厚度较均匀，内壁光滑周围有卫星灶，多位于上叶尖后段及下叶背段，增强扫描空洞壁，可有轻至中等强化。肺脓肿脓腔：多为厚壁空洞，内壁光滑，内可出现液平面，周围有渗出性炎性灶，临床症状典型。肺霉菌病空洞可为薄壁亦可为厚壁，多发常见，内壁亦可凹凸不平，部分可见空气新月征，其它良性病变空洞形成有各自特点，与肺癌空洞有相应鉴别诊断要点。结论认识并掌握肺部良恶性空洞常见CT表现，认真分析病灶形态、密度、边缘与大小并测量空洞区域的CT值变化，空洞壁的强化程度并结合临床表现及其它检查，综合分析判断，有助于减少误诊。
목적：제고폐암공동형성적CT진단여감별진단수평。방법수집경림상、실험실급수술학진적37례폐암공동급적자료완정，급기타량성공동여공강성병변34례적CT도상진행회고성분석。결과폐암공동주요CT표현유：후벽편심성공동，가유벽결절，내벽요철불평가유분협정、모자정、흉막요함정등악성종류정상증강소묘공동벽중등지명현강화；결핵성공동벽박、후도교균균，내벽광활주위유위성조，다위우상협첨후단급하협배단，증강소묘공동벽，가유경지중등강화。폐농종농강：다위후벽공동，내벽광활，내가출현액평면，주위유삼출성염성조，림상증상전형。폐매균병공동가위박벽역가위후벽，다발상견，내벽역가요철불평，부분가견공기신월정，기타량성병변공동형성유각자특점，여폐암공동유상응감별진단요점。결론인식병장악폐부량악성공동상견CT표현，인진분석병조형태、밀도、변연여대소병측량공동구역적CT치변화，공동벽적강화정도병결합림상표현급기타검사，종합분석판단，유조우감소오진。
Objective To improve the void formation of CT diagnosis and differential diagnosis of lung cancer cavity.Methods The CT imaging data of 37 cases of lung cancer cavity which approved by Operation and pathology was collected, and compared with the 34 cases of benign hollow and empty lesions.Results The main performance of CT of lung cancer cavity include: thick wall and eccentric hole ,sign of lobulation,sign of spicule,pleural indentation sign, enhancement scanning reinforced hollow walls moderately to clear; Tuberculous cavity could manifested as thin wall, uniform thickness, smooth inner wall around with satellite foci, in after the blade tip period and lower lobe dorsal segment, enhanced scan and empty wall can have light to moderate strengthening. Pulmonary abscess: thick and smooth wall,fluid level, with exudative inflammatory lesion around then cavity, and typical clinical symptoms. Lung mycosis cavity could be manifested as thick or thin wall, comose, coarse inwall, part of the visible air crescent sign. Other benign lesions cavity formed their own characteristics, empty have a corresponding key points of differential diagnosis. With lung cancer.Conclusion Understanding and mastering the common CT manifestations benign and malignant lung empty , carefully analysis lesion form, density, edge , size and CT value of measuring hole area change, hollow wall reinforcement degree in combination with clinical manifestations and other inspections, comprehensive analysis and judgment helps to reduce the misdiagnosis.