摘要
目的分析肺放线菌病的CT表现及误诊原因，以提高临床诊断率。方法回顾性分析11例经病理证实的肺放线菌病患者的CT资料，其中6例在平扫基础上行增强检查。结果11例患者中，病变位于肺下叶7例，上叶4例；9例累及2个及以上肺段，其中6例累及2个肺叶；病灶均呈团块或结节状，6例可见节段性实变；病灶内部均可见不规则斑片状低密度区，增强扫描周围实性部分可见明显渐进性强化；11例均可见胸膜增厚，6例可见胸膜外脂肪沉积；1例累及胸壁及肋骨。结论肺放线菌病的团块样表现易被误诊为肺部肿瘤或其他病变，CT增强扫描病灶呈外周延迟强化，具有一定特征性。
Objective To scrutinize the CT features of pulmonary actinomycosis and analysize the causes of misdiagnosis. Methods CT images of eleven patients with pulmonary aetinomycosis proved by pathology were retrospectively reviewed. Among them, 6 were scanned with additional enhanced CT scan. Results Among the 11 patients, the lesions located in the inferior lobe in 7 patients, and in the superior lobe in 4 patients. The lesions affected two or more pulmonary segments in 9 patients, 6 of them involving two lobes. Irregular mass or nodules with necrotic low-attenuation areas were the main signs in all patients, and segmental consolidations were found in 6 patients. Peripherally progressive enhancement was found in all patients with contrast enhanced CT scan. Vicinity pleural thickening was found in 11 patients, while extrapleural fat deposition was found in 6 patients. One case showed erosion of the chest wall and rib. Conclusion Pulmonary actinomycosis is a chronic suppurative granulomatous inflammation, which is often misdiagnosed with neoplasm or other lung disease because of its mass-like performance. The peripherally progressive enhancement on CT has a certain diagnostic value for P／pulmonary actinomycosis.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2013年第6期509-512,共4页
Chinese Journal of Radiology
