| 马超豪,李琦,陈辉月.肺炎性肺癌与渗出为主型肺结核的CT影像分析[J].中国医学影像技术,2020,36(6): |
| 肺炎性肺癌与渗出为主型肺结核的CT影像分析 |
| Differential CT features of pneumonia-type lung cancer and exudation-predominantpulmonary tuberculosis |
| 投稿时间：2019-07-26 修订日期：2020-06-15 |
| DOI： |
| 中文关键词: 肺肿瘤 肺结核 体层摄影术，X线计算机 |
| 英文关键词:Lung neoplasms Pulmonary tuberculosis 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); 重庆市卫计委项目医学科研计划项目面上项目(2017MSXM010)[第一作者]马超豪(1988-),男,四川人,硕士,医师,研究方向：胸部影像诊断学。E-mail:157635697@qq.com[通讯作者]李琦,重庆医科大学附属第一医院放射科,400016,E-mail: zhuoshui@sina.com. |
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| 中文摘要: |
| 目的：探讨肺炎性肺癌与渗出为主型肺结核的临床及CT表现差异。方法：回顾性分析84例肺炎性肺癌和93例渗出为主型肺结核患者的临床及CT资料,分别对两组年龄、临床症状和CT表现进行对比分析。结果：从年龄来看,肺癌组平均年龄(60.6±12.4岁)大于结核组(54.0±18.5岁),差异有统计学意义(P＜0.05)。从临床症状来看,结核组发热和盗汗的发生率显著高于肺癌组,而肺癌组胸痛的发生率显著高于结核组(P均＜0.05)；两组咳嗽、咳痰及咯血发生率的差异均无统计学意义(P＞0.05)。从CT表现来看,结核组单发实变影35例(37.6%),多发实变影58例(62.4%)；肺癌组单发实变影35例(41.7%),多发实变影49例(58.3%),两组在实变影数目上无显著差异(P＞0.05)。单发实变影中,结核组左右肺分布大致相同(54.3% vs 45.7%),而肺癌组以右肺多见(71.4%)；结核组单发实变影以上叶多见(71.4%),而肺癌组单发实变影以下叶多见(62.9%)。实变影密度不均者以肺癌组多见,且肺癌组实变影平扫CT值(25.7±9.5HU)低于结核组(29.6±7.7HU),差异有统计学意义(P＜0.05)；结核组与肺癌组充气支气管征的出现率无显著差异(97.8% vs 96.4%, P＞0.05),但肺癌组以枯枝型多见(74.1%),结核组以青枝型多见(63.7%)(P＜0.05)；结核组实变影中含气腔隙的出现率显著高于肺癌组(76.3% vs 53.6%,P＜0.05),但是肺癌组含气腔隙内常见分隔(66.7%),结核组含气腔隙内多无分隔(77.5%)(P＜0.05)；肺癌组磨玻璃密度影的出现率显著高于结核组(55.9% vs 86.9%,P＜0.05),而结核组伴随结节影的出现率显著高于肺癌组(62.4% vs 46.4%,P＜0.05),两组胸腔积液出现率差异无统计学意义(P＞0.05)。结论：肺炎性肺癌与渗出为主型肺结核在年龄、临床症状及CT表现方面均存在差异,当实变影密度较低且不均,其内出现枯枝型充气支气管征及有分隔的含气腔隙,同时存在磨玻璃密度影时需高度警惕肺炎性肺癌的可能。 |
| 英文摘要: |
| : Object: To analysis the CT features and clinical characteristics of pneumonia-type lung cancer and exudation-predominant pulmonary tuberculosis. Methods: The clinical materials and CT images of 84 pneumonia-type lung cancer patients and 93 patients with exudation-predominant pulmonary tuberculosis were reviewed respectively. The age, clinical characteristics and CT features of two groups were compared. Results: The average age of lung cancer group(60.6±12.4 years) was older than that of tuberculosis group(54.0±18.5 years)(P＜0.05). The fever and night sweat were displayed in the tuberculosis group significantly more than the lung cancer group(P＜0.05), but the chest pain were displayed in the lung cancer group significantly more than the tuberculosis group( P＜0.05). There were no significant differences between the two groups in the incidence of cough, expectoration and hemoptysis( P＞0.05). On CT images, 35 cases of solitary consolidation accounted for 37.6% and 58 cases of multiple consolidations accounted for 62.4% in the tuberculosis group. 35 cases of solitary consolidation accounted for 41.7%, and 49 cases of multiple consolidations accounted for 58.3% in the lung cancer group. There was no significant difference between the two groups in the number of lesions. The distribution of the solitary consolidation was similar in the left and right lungs in the tuberculosis group(54.3% vs 45.7%), however it was more commonly seen in the right lung in the lung cancer group(71.4%)。The solitary consolidation was more commonly seen in the inferior lobe lung in the lung cancer group(71.4%),but it was more commonly seen in the upper lobe lung in the tuberculosis group(62.9%). TheSconsolidations show more heterogeneous density in the lung cancer group(P＜0.05). The CT value of consolidation in lung cancer group(25.7±9.5HU)was lower than that in tuberculosis group(29.6±7.7HU)(P＜0.05). There was no significant difference between the two groups in term of air bronchogram sign(97.8% vs 96.4%, P＞0.05), but the wither-stick type of air bronchogram sign was more commonly seen in the lung cancer group, green-stick type of air bronchogram sign was more commonly seen in the tuberculosis group(P＜0.05). The air-containing space was more commonly seen in the tuberculosis group(76.3% vs 53.6%,P＜0.05), but there were more septations in the air-containing space of the lung cancer group(P＜0.05). The ground glass shadow around the consolidation was more commonly seen in the lung cancer group(55.9% vs 86.9%,P＜0.05). However, the nodules were more commonly seen in the tuberculosis group. There was no significant difference between the two groups of pleural effusion. Conclusions: There were differences in age, clinical symptoms and CT manifestations between pneumonic lung cancer and exudation-predominant pulmonary tuberculosis. When the consolidations were heterogeneous density, the CT values of consolidations were lower, there were wither-stick type of air bronchogram sign and segregated air-containing space in the consolidations. It suggested that the lesions may be the pneumonia-type lung cancer. |
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