摘要
目的分析16例肺结核单发厚壁空洞(空洞壁厚度大于3mm)CT误诊为周围型肺癌空洞的原因。方法回顾性分析16例CT误诊为周围型肺癌空洞、后经病理诊断为肺结核空洞的CT资料。结果16例患者中,40岁以上者11例。空洞直径以2～4cm多见,共8例;空洞壁厚度以5～15mm多见,共9例。10例空洞外缘呈分叶征、毛刺征;6例空洞内缘不光滑;6例纵隔肺门淋巴结增大;5例胸腔积液;3例心包积液;1例胸廓骨质破坏。10例接受CT增强扫描,3例CT值强化幅度大于26HU。结论误诊的主要原因为过分强调周围型肺癌空洞的常见CT征象的特异性。合理、完善的CT扫描方案是正确诊断的前提,提高对肺结核单发厚壁空洞和周围型肺癌空洞基本CT征象的认识是减少误诊的保证。
Objective To analyze single pulmonary tuberculous thick-walled cavity misdiagnosed as peripheral lung cancer cavity on CT. Methods Clinical data and CT findings of 16 patients with single pulmonary tuberculous thick-walled cavity proven pathologically were retrospectively analyzed. Results Among ＇16 patients, 11 were over 40 years old. Diameter of the cavities in 8 patients was 2-4 cm, while thickness of the cavitary walls in 9 patients was 5-15 mm. The sublobe and spicule sign of outer margin of cavity were found in 10 patients, uneven inner wall in 6 patients, with mediastinal and pulmonary hilar lymph nodes enlargement in 6 patients, pleural effusion in 5, pericardial effusion in 3 and destruction of thoracic skeleton in one patient. Ten patients underwent contrast-enhanced CT scan, and the differences of CT values before and after con- trast injection were more than 26 HU in 3 patients. Conclusion The main cause of misdiagnosis lies on overemphasizing the common CT characteristics of peripheral lung cancer cavities. Reasonable and consummate CT scan program is the premise for correct diagnosis. It is a guarantee to reduce CT misdiagnosis rate by means of improving understanding of basic CT features of single pulmonary tuberculous thick-walled cavity and peripheral lung cancer cavity.
出处
《中国医学影像技术》
CSCD
北大核心
2009年第8期1387-1389,共3页
Chinese Journal of Medical Imaging Technology
关键词
肺肿瘤
肺结核
空洞
误诊
体层摄影术
X线计算机
Lung neoplasms
Pulmonary tuberculosis
Cavity
Misdiagnosis
Tomography, X-ray computed
