肺孤立性炎性结节的CT诊断.docVIP

肺孤立性炎性结节的CT诊断 刘 伟 长宁区中心医院 影像科 上海市 200336 摘要 目的 探讨肺孤立性炎性结节的CT特征。材料与方法 回顾性分析23例经手术病理或临床证实的肺内单发炎性结节的CT表现。全部患者行螺旋CT平扫及增强扫描，结节范围行薄层靶扫描，多平面重建。除常规肺窗、纵膈窗观察外，调节窗宽、窗位以显示结节特征。结果 所有结节均无钙化、卫星灶、血管集束及肺门、纵膈淋巴结肿大。结节大小10×15-30×40mm，以类圆形和不规则形为主。浅分叶3例，无分叶20例。有毛刺者2例，充血征、模糊征阳性19例，胸膜反应性增厚18例，增强扫描不均匀边缘强化18例，无强化者5例。窗宽1000-2000，窗位-400左右，病灶周围渗出性改变的显示最佳。多平面重建（MPR）显示结节形态及与胸膜的关系最为准确。结论 肺内孤立性炎性结节具有较明显的CT特征，综合分析各种表现，绝大多数能做出正确诊断。窗宽、窗位的选择及MPR对显示结节特征有很大帮助。 关键词：肺结节，CT CT Diagnosis of Solitary Inflammatory Nodules of the Lung Liu Wei Department of Radiology, Central Hospital of Chang-ning District, Shanghai, 200336, P.R.China [Abstract] Objective: To evaluate the CT features of solitary inflammatory nodules of the lung. Material and Methods: CT features twenty-three cases of solitary inflammatory nodules of the lung confirmed by operation or clinical were analyzed with CT retrospectively. Spiral CT including plainscans and contrastenhanced scans was done for all of patients. Thin-slice target scan and multiple plane reconstruction were used on the area of nodule. Different width and level were used to show the characteristic sign of the nodules. Result: No calcification、satellite lesion、concentrated vessels and enlarged lymph nodes were found in or around all of the nodules. The size of these nodules were 10×15-30×40 mm with round or irregular margin. Superficial lobular or speculated margin was seen in only three nodules. Hyperemia and clouding appearance were found in 19 nodules and reflecting thickening pleura in 18 nodules. Unsteady edge enhancement was found in 18 nodules and no enhancement in 5 nodules. Effused change around the nodules could be seen perfectly when the level was about –400. MPR was the most accurate technique to show the relationship of nodule and pleura. Conclusion: Solitary inflammatory nodules of the lung had obvious CT character. By analyzing various CT manifestations comprehensively, most nodules could be diagnosed correctly. Suitable width and level, MPR are helpful