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目的 探讨肺部孤立球形病变的X线、CT表现差异 ,提高对肺部孤立球形病变的正确诊断率。方法 手术及病理证实的肺部孤立球形病变 5 1例 ,其中周围型肺癌 2 6例 ,炎性假瘤 14例 ,结核球 11例 ,全部病例均摄取胸部正侧位片及CT片。结果 (1)征象特点 :小泡征、胸膜凹陷征、阻塞性肺炎仅见于周围型肺癌 ;小于 3cm薄壁空洞为周围型肺癌的少见征象之一 ;炎性假瘤、结核球可出现不规则厚壁偏心空洞 ;棘状突起除周围型肺癌多见外 ,炎性病变亦可出现 ;支气管充气征、长毛刺、胸膜尾征炎性假瘤出现率高 ;钙化、胸膜肥厚结核球多见。 (2 )X线、CT表现差异 :肿块密度、分叶、棘状突起、纵隔淋巴结肿大的观察CT优于胸片 ,病灶形态、边缘的显示胸片较CT优越。 (3)CT对周围型肺癌、炎性假瘤、结核球定性诊断的准确性优于X线 (Ρ <0 .0 5 )。结论 认识肺部孤立球形病变的征象差异并合理选用X线、CT检查 ,有助于提高肺部孤立球形病变的正确诊断率。
OBJECTIVE: To investigate the difference of X-ray and CT appearances of solitary spherical lesions in lung and to improve the correct diagnosis rate of solitary spherical lesions in the lung. Methods Fifty-one cases of isolated spheroid lung lesions were confirmed by surgery and pathology, including 26 cases of peripheral lung cancer, 14 cases of inflammatory pseudotumor and 11 cases of tuberculous mellitus. All the patients underwent chest radiograph and CT scan. Results (1) Characteristics of the signs: vesicular syndrome, pleural indentation, obstructive pneumonitis seen only in peripheral lung cancer; less than 3cm thin-walled hollow peripheral lung cancer is one of the rare signs of inflammatory pseudotumor, tuberculin can be irregular Thick wall eccentric hole; spine-like protrusions in addition to more common around the peripheral lung cancer, inflammatory lesions can also occur; bronchial signs of inflammation, long burr, pleural tail inflammatory inflammatory pseudotumor high incidence; calcification, pleural thickening of the common tuberculoma. (2) X-ray, CT showed differences: mass density, lobulation, spinous process, mediastinal lymph node enlargement observed CT is better than chest X-ray, lesion morphology, the edge of the chest radiograph showed superior to CT. (3) CT was superior to X-ray in the qualitative diagnosis of peripheral lung cancer, inflammatory pseudotumor and tuberculoma (P <0.05). Conclusion It is helpful to recognize the difference of signs of solitary spherical lesions in the lungs and choose the appropriate X-ray and CT examination to improve the correct diagnosis rate of isolated spherical lesions in the lungs.