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目的探讨肺结核与周围型肺癌空洞的CT表现,评价CT对其鉴别诊断的价值。方法搜集经手术病理或临床追踪证实的肺结核空洞32例和周围型肺癌空洞46例,78例均作螺旋CT平扫及增强扫描。回顾性分析其CT表现。结果肺结核空洞常位于上叶尖后段,以薄壁相对多见,洞壁厚薄较均匀,周围常有卫星灶,纵膈肿大的淋巴结增强扫描呈环形强化以肺结核最常见。而癌性空洞一般为位于上叶前段,厚壁,内缘凹凸不平,有壁结节,分叶及胸膜凹陷征多见,纵膈肿大淋巴结平扫有中心坏死。结论空洞的部位,空洞壁的厚薄及其是否有壁结节,周围有无卫星灶、空洞外缘分叶的深浅、空洞壁CT强化的幅度、胸膜凹陷征及纵膈淋巴结情况是其鉴别的要点。
Objective To investigate the CT findings of tuberculosis and peripheral lung cancer and evaluate its value in differential diagnosis. Methods Thirty-two cases of pulmonary tuberculosis and 46 cases of peripheral lung cancer confirmed by pathology or clinical follow-up were collected. All 78 cases underwent spiral CT scan and enhanced scan. The CT findings were retrospectively analyzed. Results Pulmonary tuberculosis often located in the posterior segment of the upper tip of the thin-walled relatively common, more uniform thickness of the wall, often surrounded by satellite lesions, mediastinal lymph nodes enlargement enhanced scan ring enhancement to the most common pulmonary tuberculosis. The cancerous cavity is generally located in the anterior segment of the upper lobe, thick, uneven inner wall, wall nodules, lobulation and pleural indentation more common mediastinal lymph node dissection with central necrosis. Conclusions The location of the hollow, the thickness of the hollow wall and whether there are nodules, the presence or absence of satellite spots, the depth of the lobes of the hollow rim, the extent of CT enhancement of the hollow wall, pleural indentation and mediastinal lymph nodes are the main points of identification .