球形肺炎的影像学诊断与鉴别诊断(附32例分析)
肺炎;体层摄影术,X线计算机;诊断,鉴别,,],肺炎;体层摄影术，X线计算机;诊断，鉴别,1资料与方法,2影像学表现,3讨论,[参考文献]
[摘要] 目的 探讨球形肺炎的影像学特点，以便与其他球形病灶，特别是周围型肺癌做出鉴别诊断。方法 搜集32例经临床证实的球形肺炎的临床和CT、X线平片检查资料，进行回顾性分析。结果 32例球形肺炎的主要表现：(1)病变两侧缘垂直于胸膜呈刀切样平直边缘，病变呈方形，是球形肺炎的特征；(2)病变局部及周围胸膜肥厚；病变所属支气管非狭窄性均匀增厚；肺门侧血管增多、增粗、扭曲，但无僵直及牵拉；病变非胸膜侧浅淡小片状高密度等强烈支持球形肺炎诊断；(3)抗炎治疗后病变疏散或明显缩小支持球形肺炎，提示可以继续抗炎治疗；(4)纵隔、肺门无明显淋巴结肿大，趋向支持肺炎诊断；(5)晕征、支气管充气征、病灶内肺泡征，不能过分强调其诊断价值。首诊平片显示病变的病例，平片可作为经济、简便有效的随诊方法。结论 CT检查是球形肺炎诊断和鉴别诊断的有效方法。[关键词] 肺炎;体层摄影术，X线计算机;诊断，鉴别
Imaging and differential diagnosis of spherical pneumonia:a report of 32 cases
YANG Yue，HAO Jingming,HU Chunai,et al.Department of Radiology,Xuzhou Hospital,Medical School of Southeast University,Xuzhou 221009,China
[Abstract] Objective To evaluate the imaging features of spherical pneumonia (SP)and to differentiate it from other spherical lesions,particularly in pulmonary carcinoma.Methods 32 cases of SP clinically proved were analyzed retrospectively.Results The CT findings were as follows:(1)Bilateral margins of the lesions were perpendicular to pleura with a straight cutedge presenting a square sign.(2)Following manifestations strongly means SP:adjacent pleural thickness;symmetrical bronchial wall thickness without bronchial stenosis;intensified vascular markings but not hardening;small patches of slight high density around lesions apart from pleura (3)Reduce of lesions after antiinflammatory therapy was inclined to SP.(4)There were not mediastinal and hilar lymph enlargememt.(5)“Halosign”,“bronchiologram”,“vacuole” were not special to SP.Conclusion CT exam is a effective way of diagnosis and differentiation to SP. ......
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