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目的探讨肺炎性假瘤的CT诊断及思路。方法回顾性分析30例经穿刺活检、手术病理证实的肺炎性假瘤的CT平扫表现及有关临床资料。结果本组肺炎性假瘤发生在右下叶8例,右上叶7例,中叶者3例;左下叶8例,左上叶4例。病灶密度均匀24例,病灶呈类圆形或椭圆形者26例,团片状3例,哑铃状1例;边缘出现“桃尖征”9例,周围长毛刺征6例,支气管气象4例,空洞征4例,沙砾样钙化2例,空泡征1例;21例病灶与相邻组织的界线清晰并有轻度压迫征象,17例出现相邻胸膜肥厚粘连,3例纵隔内见肿大淋巴结,相邻骨质未见破坏。结论CT平扫对肺炎性假瘤的诊断有一定价值,但也有明显局限性,应完善CT增强扫描检查,此外,CT引导下肺穿刺活检术是作出诊断的重要手段。
Objective To investigate the CT diagnosis and thoughts of pulmonary inflammatory pseudotumor. Methods A retrospective analysis of 30 cases of puncture biopsy, surgical pathology confirmed pulmonary inflammatory pseudotumor CT scan performance and clinical data. Results In this group, 8 cases were found in right lower lobe, 7 cases in right upper lobe, 3 cases in middle lobe, 8 cases in left lower lobe and 4 cases in left upper lobe. Twenty-four lesions were uniformly distributed in density, with 26 cases of round or oval lesions, 3 cases of pelvis and 1 cases of dumbbell shape, 9 cases of peach appendectomy on the edge, 6 cases of peripheral prickles and 4 cases of bronchial meridian , Empty sign in 4 cases, gravel-like calcification in 2 cases and vacuolization in 1 case. The borderline between 21 lesions and adjacent tissues was clear and slight compression signs, adjacent pleural thickening adhesions in 17 cases, intra-mediastinal swelling in 3 cases Large lymph nodes, adjacent bone no damage. Conclusion CT scan has some value in the diagnosis of pneumonectomy, but there are obvious limitations. CT scan should be improved. In addition, CT-guided lung biopsy is an important method for diagnosis.