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目的探讨螺旋CT动态增强扫描在肺炎性假瘤伴氟中毒诊断中的应用效果。方法回顾性分析本院确诊并治疗的肺炎性假瘤伴氟中毒的病例12份,收集其增强CT的影响学表现及临床资料。结果病灶部位,12例炎性假瘤均为单发病灶,其中5例位于左下肺、3例位于右下肺、2例位于右肺上叶、1例位于左肺中叶、1例位于左肺上叶;病灶形态,2例呈圆形或椭圆形,边缘清晰锐利,CT值25~45Hu;10例呈团块状,边缘不清呈现锯齿状,密度不均匀且病灶大小也不相同,其中2例有分叶表现,7例垂直于胸膜分布且边缘呈刀切样;1例表现为肺不张的形态。氟中毒的CT表现主要表现为肺外带纹理增多,合并多个细条影及网格影,其中间质性肺水肿2例、肺泡性肺水肿1例、6例为肺纤维化的表现、3例仅见胸膜下线。此外,氟中毒患者多伴有支气管扩张、胸腔积液及胸膜肥厚等影像学表现。结论肺炎性假瘤的CT表现结合患者肺部症状及氟裂解气接触史能够提高肺炎性假瘤伴氟中毒的诊断及鉴别诊断的准确率。
Objective To investigate the application of spiral CT dynamic contrast-enhanced scanning in the diagnosis of pulmonary inflammatory pseudotumor with fluorosis. Methods Retrospective analysis of 12 cases of pneumococcal pseudotumor with fluorosis confirmed and treated in our hospital. The CT findings and clinical data were collected. Results The lesion site and the 12 inflammatory pseudotumor were all single lesions. Among them, 5 were in the left lower lung, 3 in the right lower lung, 2 in the right upper lobe, 1 in the middle left lung and 1 in the left lung Upper lobe; Lesion morphology, 2 cases were round or oval, sharp and sharp edges, CT value 25 ~ 45Hu; 10 cases were clumpy, jagged edge unclear, uneven density and lesion size is not the same 2 cases showed lobular, 7 cases were perpendicular to the pleura and the edge was knife-like; 1 case showed atelectasis. CT manifestations of fluorosis mainly as extranodal lung texture increased, combined with multiple thin bars and grid shadow, including two cases of interstitial pulmonary edema, alveolar pulmonary edema in 1 case, 6 cases of pulmonary fibrosis performance, 3 Cases only see the subpleural line. In addition, fluorosis patients are often accompanied by bronchiectasis, pleural effusion and pleural hypertrophy and other imaging findings. Conclusion The CT findings of pneumonectatic pseudotumor can improve the diagnostic and differential diagnostic accuracy of pulmonary inflammatory pseudotumor with fluorosis in combination with pulmonary symptoms and fluoride exposure history.