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目的评价螺旋CT在胸部结节病首次检查中的诊断准确性及其在治疗后复查中的作用。方法回顾性分析具有完整临床及影像资料且经手术、病理或临床治疗证实的胸部结节病25例,所有病例做了胸部X线检查和胸部CT扫描。结果25例胸部结节病,首次检查正确诊断16例,误诊9例。结节病的典型影像学表现:(1)右侧气管旁、左侧肺门、右侧肺门淋巴结肿大,增强后肿大淋巴结呈均匀、中高度强化;(2)支气管血管束呈串珠状增粗、两肺多发结节是结节病的肺部典型表现。首诊误诊的9例为不典型结节病,其中误诊为淋巴瘤5例、结核病1例、肺门纵隔淋巴结转移2例、肺部转移性肿瘤1例。结论螺旋CT对胸部结节病的明确诊断起着不可替代的作用;CT复查能对其治疗效果作出准确客观的评价。
Objective To evaluate the diagnostic accuracy of spiral CT in the first examination of thoracic sarcoidosis and its role in post-treatment review. Methods A total of 25 cases of thoracic sarcoidosis confirmed by surgery, pathology or clinical treatment with complete clinical and imaging data were retrospectively analyzed. All cases were examined by chest X-ray and chest CT scan. Results 25 cases of thoracic sarcoidosis, the first check correct diagnosis of 16 cases, misdiagnosis in 9 cases. Sarcoidosis typical imaging findings: (1) the right tracheal, left hilar and right hilar lymph nodes, enlarged lymph nodes after enhancement showed a uniform, highly enhanced; (2) the bronchial vascular bundle was beaded Proliferation, multiple lung nodules is a typical manifestation of sarcoidosis in the lungs. The first misdiagnosed 9 cases of atypical sarcoidosis, misdiagnosed as lymphoma in 5 cases, tuberculosis in 1 case, hilar mediastinal lymph node metastasis in 2 cases, lung metastatic tumor in 1 case. Conclusion Spiral CT plays an irreplaceable role in the diagnosis of chest sarcoidosis. CT review can accurately and objectively evaluate its therapeutic effect.