| 马超豪,李琦,陈辉月.对比观察炎性肺癌与渗出为主型肺结核CT表现[J].中国医学影像技术,2020,36(6):849~852 |
| 对比观察炎性肺癌与渗出为主型肺结核CT表现 |
| Comparison on CT manifestations of pneumonic-type lung cancer and exudation-predominant pulmonary tuberculosis |
| 投稿时间：2019-07-26 修订日期：2020-03-06 |
| DOI：10.13929/j.issn.1003-3289.2020.06.010 |
| 中文关键词: 肺肿瘤 结核,肺 体层摄影术,X线计算机 |
| 英文关键词:lung neoplasms tuberculosis, pulmonary tomography, X-ray computed |
| 基金项目:重庆市科学技术委员会基础科学与前沿技术研究项目（cstc2017jcyjAX0281）、重庆市卫生计生委2017年医学科研计划项目（2017MSXM010）。 |
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| 中文摘要: |
| 目的 对比观察炎性肺癌与渗出为主型肺结核的CT表现。方法 回顾性分析84例炎性肺癌（肺癌组）和93例渗出为主型肺结核（结核组），比较2组病变CT表现（实变数目、单发实变分布、实变影密度、实变影内充气支气管征和含气腔隙、实变影周围磨玻璃密度（GGO）、伴随结节影、胸腔积液及纵隔淋巴结是否肿大及钙化）的差异。结果 2组实变数目差异无统计学意义（χ2=0.30，P>0.05）。结核组单发实变影双肺分布大致相同，以上叶多见；肺癌组中以右肺及下叶多见。2组充气支气管征发生率差异无统计学意义（χ2=0.33，P>0.05）；肺癌组以枯枝型多见，结核组以青枝型多见（χ2=24.67，P<0.05）。结核组实变影中含气腔隙发生率高于肺癌组（χ2=10.13，P<0.05），含气腔隙内分隔多见于肺癌组（χ2=22.42，P<0.05）。相比结核组，肺癌组病灶密度多不均匀，GGO多见（χ2=5.27，20.43，P均<0.05）而伴随结节影少见（χ2=4.53，P<0.05）。结论 炎性肺癌与渗出为主型肺结核CT表现存在一定差异；实变影密度不均伴枯枝型充气支气管征及有分隔的含气腔隙、同时存在GGO时，需高度警惕炎性肺癌。 |
| 英文摘要: |
| Objective To comparatively analyze CT manifestations of pneumonic-type lung cancer and exudation-predominant pulmonary tuberculosis. Methods CT data of 84 patients with pneumonic-type lung cancer (lung cancer group) and 93 with exudation-predominant pulmonary tuberculosis (tuberculosis group) were retrospectively analyzed. CT manifestations were compared between 2 groups, including the number of consolidation shadows, distribution of single consolidation shadows, density of consolidation shadows, internal air bronchogram and air lacunae in consolidation shadows, ground-glass opacity (GGO) around consolidation shadows, accompanying nodule shadows, pleural effusion as well as swelling and calcification of mediastinal lymph nodes. Results No statistical difference of the number of consolidation shadows was observed between 2 groups (χ2=0.30, P>0.05). In tuberculosis group, distribution of single consolidation shadow in both lungs was similar and in upper lobe was common, while in lung cancer group, distribution in right lung and lower lobe were common. There was no statistical difference of air bronchogram between groups (χ2=0.33, P>0.05). Wither-stick type of air bronchogram was often observed in lung cancer group, while green-stick type was commonly found in tuberculosis group (χ2=24.67, P<0.05). The incidence of air lacunae in tuberculosis group was higher than in lung cancer group (χ2=10.13, P<0.05), and septation within air lacunae was more common in lung cancer group than in tuberculosis group (χ2=22.42, P<0.05). Compared with tuberculosis group, lung cancer group had more uneven density of lesions and more GGO around consolidation shadows (χ2=5.27, 20.43, P<0.05) but less accompanying nodules (χ2=4.53, P<0.05). Conclusion CT manifestations of pneumonic-type lung cancer and exudation-predominant pulmonary tuberculosis are different to some extent. Heterogeneous consolidation with wither-stick type of air bronchogram and segregated air-containing space combined with GGO around highly suggest pneumonic-type lung cancer. |
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