CAJ | 학술논문

目的分析肺放线菌病的CT表现及误诊原因,以提高临床诊断率.方法回顾性分析11例经病理证实的肺放线菌病患者的CT资料,其中6例在平扫基础上行增强检查.结果 11例患者中,病变位于肺下叶7例,上叶4例；9例累及2个及以上肺段,其中6例累及2个肺叶；病灶均呈团块或结节状,6例可见节段性实变；病灶内部均可见不规则斑片状低密度区,增强扫描周围实性部分可见明显渐进性强化；11例均可见胸膜增厚,6例可见胸膜外脂肪沉积；1例累及胸壁及肋骨.结论肺放线菌病的团块样表现易被误诊为肺部肿瘤或其他病变,CT增强扫描病灶呈外周延迟强化,具有一定特征性.
목적 분석폐방선균병적CT표현급오진원인,이제고림상진단솔.방법 회고성분석11례경병리증실적폐방선균병환자적CT자료,기중6례재평소기출상행증강검사.결과 11례환자중,병변위우폐하협7례,상협4례；9례루급2개급이상폐단,기중6례루급2개폐협；병조균정단괴혹결절상,6례가견절단성실변；병조내부균가견불규칙반편상저밀도구,증강소묘주위실성부분가견명현점진성강화；11례균가견흉막증후,6례가견흉막외지방침적；1례루급흉벽급륵골.결론 폐방선균병적단괴양표현역피오진위폐부종류혹기타병변,CT증강소묘병조정외주연지강화,구유일정특정성.
Objective To scrutinize the CT features of pulmonary actinomycosis and analysize the causes of misdiagnosis.Methods CT images of eleven patients with pulmonary actinomycosis proved by pathology were retrospectively reviewed.Among them,6 were scanned with additional enhanced CT scan.Results Among the 11 patients,the lesions located in the inferior lobe in 7 patients,and in the superior lobe in 4 patients.The lesions affected two or more pulmonary segments in 9 patients,6 of them involving two lobes.Irregular mass or nodules with necrotic low-attenuation areas were the main signs in all patients,and segmental consolidations were found in 6 patients.Peripherally progressive enhancement was found in all patients with contrast enhanced CT scan.Vicinity pleural thickening was found in 11 patients,while extrapleural fat deposition was found in 6 patients.One case showed erosion of the chest wall and rib.Conclusion Pulmonary actinomycosis is a chronic suppurative granulomatous inflammation,which is often misdiagnosed with neoplasm or other lung disease because of its mass-like performance.The peripherally progressive enhancement on CT has a certain diagnostic value for P\pulmonary actinomycosis.