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目的探讨发生在两上肺的机化性肺炎的螺旋CT及PET-CT特征以提高对其的诊断及鉴别能力。方法对83例经手术病理证实的两上肺机化性肺炎螺旋CT表现及其中7例PET-CT进行回顾性分析,探讨病变的发生部位、形态、大小、边缘、密度、增强及糖代谢水平等影像学特征。结果病变在肺野外、中、内带均有发生,病灶呈团块、结节、不规则条片态及楔形等多种形态,以长轴/短轴比值平均>1.7的不规则条片状及楔形最具特征,边缘多毛糙、模糊,78例(93%)边缘可见长、短毛刺,38例(46%)出现胸膜增厚或牵拉,22例(27%)平扫病灶内示单或多发类圆形透亮区,5例(6%)出现形态不规则空洞,增强后平扫出现的类圆形透亮区均无强化,8例出现单、多发类圆形无强化低密度或蜂窝状改变,仅3例呈环形强化,实变区域以明显强化为主且有延时强化趋势,部分病灶内出现完整的肺血管树影。7例PET-CT均有不同程度糖代谢增高,均值达10。结论胸膜下楔形实变影或不规则长条片影,内有多发小圆形透亮区/无强化区和完整的肺血管影,相邻胸膜条带状增厚,糖代谢水平不同程度增高是上肺机化性肺炎CT及PET-CT常见表现,加深对这些特点的认识,能提高其诊断准确性及尽量避免误诊。
Objective To investigate the characteristics of spiral CT and PET-CT in the two upper lungs of patients with opportunistic pneumonia to improve its ability of diagnosis and identification. Methods The spiral computed tomography (CT) findings of 7 cases and 2 PET-CT of 7 cases confirmed by surgery and pathology were retrospectively analyzed. The location, shape, size, margin, density, enhancement and glucose metabolism Other imaging features. Results The lesions were found in the lungs in the middle, the middle and the inner zones. The lesions were in the form of clumps, nodules, irregular strips and wedges. The irregular strips with an average ratio of major axis to minor axis> 1.7 And the most characteristic wedge, the edge more rough and fuzzy, fuzzy, 78 cases (93%) edge can be seen long and short burr, 38 cases (46%) pleural thickening or traction, 22 cases (27% Or multiple class of round translucent area, 5 cases (6%) showed irregular cavities, enhancement after plain type of circular translucent area showed no enhancement, 8 cases of single, multiple types of circular non-enhanced low density or honeycomb Like changes, only 3 cases were ring-shaped enhancement, the consolidation area was significantly enhanced and there is a trend of delay of enhancement, some lesions appear complete pulmonary vascular tree shadow. Seven cases of PET-CT increased glucose metabolism in varying degrees, with an average of 10. CONCLUSIONS: Subpleural wedge-shaped consolidation or irregular long-shadows, multiple small circular translucent area / no enhancement area and complete pulmonary vascular shadow, thickening of the adjacent pleural strips, increased levels of glucose metabolism is The common manifestations of CT and PET-CT of pulmonary-localized pneumonia deepen the understanding of these features, which can improve the diagnostic accuracy and avoid misdiagnosis as much as possible.