CAJ | 학술논문

目的：探讨CT扫描鉴别诊断马红球菌肺脓肿与肺部空洞病变的价值。方法马红球肺脓肿患者16例，肺结核性厚壁空洞患者12例，肺癌性空洞患者7例，行胸部CT常规平扫及增强扫描，对平扫、增强30 s、60 s CT值进行比较分析。结果16例马红球菌肺脓肿患者中，多发空洞11例，单发空洞5例；增强CT扫描空洞壁造影剂浓度呈速升速降变化。12例结核性厚壁空洞患者，多发空洞5例，单发空洞7例；增强CT扫描空洞壁造影剂浓度呈速升速缓降变化。7例癌性空洞患者均为单发空洞，增强CT扫描空洞壁造影剂浓度呈速升缓降变化。结核空洞组的平扫CT值、增强30 s CT值、增强60 s CT值均高于马红球菌肺脓肿组、癌性空洞组（P＜0．05）；而马红球菌肺脓肿组与肺癌性空洞壁组的平扫CT值、增强30 s CT值、增强60 s CT值比较，差异无统计学意义（ P＞0．05）。结论 CT平扫、动态增强扫描对马红球菌肺脓肿、肺结核空洞、空洞型肺癌的鉴别诊断有一定临床价值。
목적：탐토CT소묘감별진단마홍구균폐농종여폐부공동병변적개치。방법마홍구폐농종환자16례，폐결핵성후벽공동환자12례，폐암성공동환자7례，행흉부CT상규평소급증강소묘，대평소、증강30 s、60 s CT치진행비교분석。결과16례마홍구균폐농종환자중，다발공동11례，단발공동5례；증강CT소묘공동벽조영제농도정속승속강변화。12례결핵성후벽공동환자，다발공동5례，단발공동7례；증강CT소묘공동벽조영제농도정속승속완강변화。7례암성공동환자균위단발공동，증강CT소묘공동벽조영제농도정속승완강변화。결핵공동조적평소CT치、증강30 s CT치、증강60 s CT치균고우마홍구균폐농종조、암성공동조（P＜0．05）；이마홍구균폐농종조여폐암성공동벽조적평소CT치、증강30 s CT치、증강60 s CT치비교，차이무통계학의의（ P＞0．05）。결론 CT평소、동태증강소묘대마홍구균폐농종、폐결핵공동、공동형폐암적감별진단유일정림상개치。
Objective To evaluate the value of CT scan in the differential diagnosis of Rhodococcus equi pulmonary abscess and cavitary pulmonary lesions.Methods Routine chest CT scan and enhanced CT scan were performed among 16 patients with Rhodococcus equi pulmonary abscess,12 patients with tuberculous thick-wall cavity and 7 patients with lung cancerous cavity.A comparative analysis on the values of their routine CT scan,30s-and 60s-enhanced CT scan was conducted.Results There were 11 cases of multiple cavity and 5 cases of single cavity among 16 cases of Rhodococcus equi pulmonary abscess,and enhanced CT scan showed a rapid increase and rapid decrease in the concentration of cavity-wall contrast medium.There were 5 cases of multiple cavity and 7 cases of single cavity among 12 cases of tuberculous thick-wall cavity,and enhanced CT scan showed a rapid increase and slow decrease in the concentration of cavity-wall contrast medium.All of the 7 patients with cancerous cavity were single cavity,and enhanced CT scan showed a rapid increase and slow decrease in the concentration of cavity-wall contrast medium.The values of routine CT scan,30s-and 60s-enhanced CT scan were higher in the tuberculous cavity group compared with Rhodococcus equi pulmonary abscess group and lung cancerous cavity group(P<0.05),which showed no significant difference between Rhodococcus equi pulmonary abscess group and lung cancerous cavity group(P >0.05). Conclusion Routine CT scan and dynamic enhanced CT scan are of certain clinical value in the differential diagnosis of Rhodococcus equi pulmonary abscess,tuberculous cavity and cavitary lung cancer.