摘要
目的探析非典型胸部结节病患者的CT影像学表现及CT检查在该病临床鉴别与诊断中的应用价值。方法以我院2012年5月-2015年5月收治的73例胸肺部病变患者作为研究对象进行,均以组织病理学检查结果作为最终结果,所有患者均行多层螺旋CT扫描。总结非典型胸部结节病患者的CT影像学表现,并将确诊结果与组织病理学检查结果进行对比,以明确CT的鉴别、诊断价值。结果非典型胸部结节病患者的CT影像学主要表现为胸内淋巴结肿大,多出现磨玻璃影、结节影、不规则索条影等肺部浸润表现,伴斑点状钙化,增大淋巴结界限清楚,呈明显均匀强化。共诊断出58例非典型胸部结节、2例结核、2例淋巴瘤、1例转移瘤,其余10例发生误诊或漏诊,非典型胸部结节的诊断准确率达86.6%(58/67)。非典型胸部结节病患者CT强化方式以均匀为主,达65.7%,转移瘤CT强化方式也为均匀强化,需予以鉴别;非典型胸部结节病患者CT强化程度多为明显强化,达64.2%,而结核、淋巴瘤、转移瘤等一般不出现明显强化,较好辨别。结论 CT在非典型胸部结节病患者中的应用可更清楚观察病变,利于结节病病变的定位、鉴别及诊断,具有较大临床价值。
Objective To explore the CT mtaging manifestations and the application value of CT examination in the clinical differentiation and diagnosis of patients with atypical thoracic sarcoidosis. Methods 73 patients with thoracic and lung lesions treated in our hospital from May 2012 to May 2015 were taken as the research objects. Tire results pathological examination were taken as the final results. All patients underweut multi- slice spiral CT scanning. The CT imaging manifestations of patients with atypical thoracic sarcoidosis were summarized and the cnnfimled results were compared with the results of pathological examination to clearly identify the differential and diagnostic value of CT. Results The main CT imaging manifestation of patients with atypical thoracic sarcoidosis was intrathoracic lymphadenectasis, usually with pulmonary infiltration manifestations, such as ground glass shadow, nodular shadow and irregular linear opacities, complicated with spot-like calcification, clear enlarged lymph nodes boundaries, apparently homogeneous enhancement. A total of 58 cases of atypical thoracic sarcoidosis, 2 cases of tuberculosis, 2 cases of lymphoma and 1 case of metastatic tumor were diagnosed, and the remaining 10 cases were nfisdiagnosed or missed diagnosed. The accuracy rate in the diagnosis of atypical thoracic nodules was 86.6% （58/67）. The main enhancement mode of patients with atypical thoracic sarcoidosis was homogeneous, reaching 65.7%. CT enhancement of metastatic tumor also was homogeneous enhancement, which needed to be identified. The most CT enhancement degree of patients with atypical thoracic sarcoidosis was obvious enhancelnent, reaching 64.2%, whiloe there was no obvious enhancement in tuberculosis, lymphoma and metastatic tumor, et al, which were easy to identity. Conclusion The application of CT in patients with atypical thoracic sarcoidosis can make the lesions observed more clearly, which is conducive to the localization, differentiation and diagnosis ofsarcoidosis, with great clinical value.
作者
何佳峻
张羲娥
邓珍萍
HE jia-jun ZHANG Xi-e DENG Zhen-ping.(Department of Imaging, The Second People＇s Hospital of Chengdu, Chengdu 610017, Sichuang Province, China)
出处
《中国CT和MRI杂志》
2017年第2期48-50,共3页
Chinese Journal of CT and MRI
关键词
非典型胸部结节病
CT
鉴别诊断
Atypical Thoracic Sarcoidosis
CT
Differential Diagnosis
