肺炎性假瘤的CT影像表现与误诊原因.pdf

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1、582职业与健康2011年3月第27卷第5期OccupandHealthVol．27No．5Mar2011肺炎性假瘤的CT影像表现与误诊原因【基础医学·相关疾病与临床】CTImagingFindingsandMisdiagnosisCausesofPulmonaryInflammatoryPseudotumor潘青华，邹新农，方向明PANQing-hua，ZOUXin-nong，FANGXiang-ming摘要目的探讨肺炎性假瘤的CT影像表现及误诊原因，提高诊断水平。方法对35例经手术病理证实的肺部炎性假瘤的CT影像表

2、现进行系统回顾性分析。结果肺炎性假瘤多位于肺野外周，局限于一叶，形态多不规则，病灶常呈广基底贴于胸膜并且邻近胸膜增厚，可见“桃尖征”、“平直征”、“晕征”等特征性表现，增强扫描多为高度均匀性强化，病灶经抗炎治疗后可缩小或无变化。术前诊断正确11例，误诊为周围型肺癌17例，结核球4例，肺错构瘤2例，肺脓肿1例，误诊率71．4%。结论全面综合地分析肺炎性假瘤CT表现特征并结合临床资料可提高肺炎性假瘤影像诊断的正确率，减少误诊。关键词肺部;炎性假瘤;螺旋CT;影像表现;诊断:误诊中国图书资料分类号:R445文献标识码:B文章

3、编号:1004－1257(2011)05－0582－03SubjectCTImagingFindingsandMisdiagnosisCausesofPulmonaryInflammatoryPseudotumorAuthorsPANQing-hua，ZOUXin-nong，FANGXiang-ming(RadiologyDepartment，WuxiPeople＇sHospital，Jiangsu，214023，China)Abstract［Objective］ToinvestigatetheCTimagingfin

4、dingsandmisdiagnosiscausesofpulmonaryinflammatorypseudotumor，soastoimprovethediagnosislevel．［Methods］CTimagingfindingsof35casesofpulmonaryinflammatorypseudotumorwhichwereconfirmedbyoperationandpathologywereanalyzedretrospectively．［Results］Thepulmonaryinflammator

5、ypseudotumormainlyloca-tedinperipherallungfield，andwaslimitedinonepulmonarylobewithirregularshape．Broad-baselesionsoftenaffixedtothepleu-rawithadjacentpleuralthickening，therewerecharacteristicperformancesof"peachsharpsign"，"flatsign"and"halosign"．Theenhancedscan

6、showedhighhomogeneousenhancement．Afteranti-inflammatorytreatment，thelesionscanbereducedornochange．11casesofpreoperativediagnosiswereaccurate，themisdiagnosisincludedperipherallungcancerin17cases，tuberculomain4ca-ses，pulmonaryhamartomain2casesandlungabscessin1case

7、，themisdiagnosisratewas71．4%．［Conclusion］Thecomprehen-siveandintegratedanalysisofCTimagingfindingscombinedwithclinicaldatacanimprovetheaccuraterateofimagingdiagnosisinpulmonaryinflammatorypseudotumor，andreducemisdiagnosis．KeywordsPulmonary;Inflammatorypseudotumo

8、r;SpiralCT;Imagingfindings;Diagnosis;Misdiagnosis肺炎性假瘤是一种由某些非特异性炎症慢性化而形成机率CT(HRCT)对病灶中心层面进行3mm薄扫。15例行平扫［1］化性肺炎，进而局限化形成的瘤样肿块。由于其表现为肺内加双期增强扫描，采用优惟显80ml肘静脉团注，注射速率2实性占位病变