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目的探讨肺结核球的CT表现及其鉴别诊断。方法选择40例经临床和病理证实的肺结核球及40例经手术病理证实的周围型肺癌,将其资料进行对比分析。结果结核球好发于背侧肺段;密度大多均匀,边界光整,部分病例可见粗长毛刺;病灶内部常见弥散小钙化点,靠近边缘的弧形钙化,钙化面积大于病灶的10%;薄、厚壁空洞内缘光整或裂隙状空洞;增强扫描病灶不强化或环状强化;病灶周围的卫星病灶及胸膜增厚;肺门、纵隔淋巴结钙化,不肿大。抗结核治疗后复查病变吸收慢或略吸收、不吸收。结论综合分析各种CT征象,结合临床资料其诊断准确率可提高;对一时不能确诊的病例,应做CT引导下穿刺检查。
Objective To investigate the CT findings and differential diagnosis of tuberculosis. Methods 40 cases of clinically and pathologically confirmed tuberculoma and 40 cases of peripheral lung cancer confirmed by surgery and pathology were selected and their data were compared. Results Tuberculoma occurred in the dorsal segment of the lung. The density was mostly uniform and the border was smooth. In some cases, coarse burrs were observed. Small diffuse calcification in the lesion, arcuate calcification near the edge, and calcification area was larger than 10% of the lesion. , Thick-walled hollow inner edge smoothing or fissure-like cavity; enhanced scan lesion is not enhanced or annular enhancement; lesion around the satellite lesions and pleural thickening; hilar and mediastinal lymph nodes calcification, no enlargement. After anti-TB treatment, the lesion is slowly absorbed or slightly absorbed, not absorbed. Conclusion Comprehensive analysis of various CT signs, combined with clinical data, diagnostic accuracy can be improved; for a time can not be confirmed cases, CT-guided puncture should be done.