论文部分内容阅读
目的：总结分析２６例原发性肺癌的ＣＴ误诊原因，旨在提高肺癌ＣＴ诊断准确性以及患者手术切除机会。方法：搜集１９９２－１９９９年间２６例ＣＴ误诊，而经手术病理或其他临床证实且资料完整的原发性肺癌病例进行回顾性分析。结果：２６例中，周围型肺癌２０例，误诊为结核瘤１０例，炎症假瘤５例．真菌感染２例，错构瘤２例，胸膜间皮瘤１例；中央型肺癌６例，误诊为纵隔淋巴瘤２例，胸腺瘤２例，肺部炎症２例。重新回顾性阅片发现，２６例肺癌中具有典型肺癌征象，可作出诊断１２例（占４６％），具有部分特征表现，而结合临床可作出诊断的６例（占２３％），其余８例（占３１％）诊断仍较困难，需作穿刺活检或剖胸探查方可能诊断。结论：原发性肺癌术前 ＣＴ误诊原因是多方面的，其中对肺癌病灶ＣＴ特征性表现征象认识不足是主要原因。加强肺癌ＣＴ征象的认识，密切结合临床，提高或改进扫描技术，争取多种影像学方法的综合应用，将是减少误诊，提高诊断准确性的关键。
Objective: To summarize the causes of CT misdiagnosis in 26 cases of primary lung cancer, and to improve the accuracy of CT diagnosis of lung cancer and the chance of surgical resection. Methods: Twenty-six cases of CT misdiagnosis between 1992 and 1999 were collected and retrospectively analyzed by pathology or other clinically confirmed and complete primary lung cancer cases. Results: In 26 cases, 20 cases of peripheral lung cancer were misdiagnosed as tuberculosis in 10 cases and inflammatory pseudotumor in 5 cases. 2 cases of fungal infection, 2 cases of hamartoma, 1 case of pleural mesothelioma; 6 cases of central lung cancer, misdiagnosed as mediastinal lymphoma in 2 cases, 2 cases of thymoma, 2 cases of lung inflammation. A retrospective review revealed that in 26 cases of lung cancer with typical signs of lung cancer, 12 cases (46%) were diagnosed, with partial features, whereas 6 cases (23%) were clinically diagnosed and the remaining 8 (31%) diagnosis is still more difficult to be puncture biopsy or thoracotomy probing may be diagnosed. Conclusion: There are many causes of misdiagnosis of preoperative CT in patients with primary lung cancer, of which the lack of understanding of CT features of lung cancer is the main reason. Strengthening the understanding of CT signs of lung cancer, and closely combining clinical, improving or improving scanning techniques and seeking comprehensive application of multiple imaging methods will be the key to reduce misdiagnosis and improve diagnosis accuracy.