论文部分内容阅读
目的分析肺内结核球病灶CT误诊原因并吸取经验教训。方法对安顺市西秀区人民医院肺内结核球CT误诊为肺癌,后经手术病理检查证实并进行诊断性抗痨治疗的18例患者CT影像学特点进行回顾。结果 18例患者中CT表现有分叶征者11例,有毛刺征者7例,且有4例伴分叶,3例伴胸膜凹陷征。4例患者可见不规则厚壁空洞,4例30～42Hu CT增强扫描后表现为不均匀强化,无包膜样强化。结论分叶征、毛刺征为肺结核球不典型CT征象,医师认识不足而易被误诊为肺癌。对肺内肺块的CT诊断要纵观全局,注重与患者病情病史的结合方可减少误诊。
Objective To analyze the cause of misdiagnosis of CT in tuberculosis of the lung and learn from the experience and lessons. Methods The CT images of 18 patients with pulmonary tuberculosis CT misdiagnosed as lung cancer in Xixiu District People’s Hospital of Anshun City and confirmed by operation and pathology examination and diagnosed with anti-tuberculosis therapy were reviewed. Results In 18 patients, there were 11 cases with lobectomy, 7 cases with spiculation, 4 cases with lobulation and 3 cases with pleural indentation. Four patients showed irregular thick-walled cavity, 4 cases of 30 ~ 42 Hu CT scan showed uneven enhancement, no capsule-like enhancement. Conclusions Leaf lobes and spicules are atypical CT signs of pulmonary tuberculosis. Physicians lack of knowledge and are easily misdiagnosed as lung cancer. Pulmonary lung CT diagnosis should look at the overall situation, pay attention to the combination of the patient’s disease history can reduce misdiagnosis.