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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、结核球做出鉴别诊断。方法搜集18例经临床病理证实的球形肺炎的临床和CT、X线平片等检查资料,进行回顾性分析。结果18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,有一定的鉴别诊断意义。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。结论肺部CT检查结合经皮肺穿刺活检是球形肺炎诊断和鉴别诊断的有效方法。
Objective To investigate the imaging features of spherical pneumonia in order to make differential diagnosis with other spherical lesions, especially peripheral lung cancer and tuberculoma. Methods The clinical data of 18 cases of spherical pneumonia confirmed by clinical pathology and CT, X - ray plain film were collected for retrospective analysis. Results The main manifestations of 18 cases of spherical pneumonia: (1) lesions on both sides of the edge perpendicular to the pleura was sliced straight edge of the knife, the lesion was square, is characterized by spherical pneumonia; (2) lesions and pleural hypertrophy around and around; lesion belongs to the bronchus Non-stricture uniform thickening; hilar vessels increased, thickening, distorting, but no stiffness and traction; Lesions non-pleural side of light flake high density strongly support the diagnosis of spherical pneumonia; (3) anti-inflammatory treatment Lesions evacuated or significantly reduced to support spherical pneumonia, suggesting that anti-inflammatory treatment can continue; (4) mediastinum, hilar no obvious lymph nodes, tend to support the diagnosis of pneumonia; (5) halo sign, bronchial inflatable sign, A certain significance of differential diagnosis. The first plain film showed lesions, plain film can be used as an economical, simple and effective follow-up method. Conclusion Pulmonary CT examination combined with percutaneous lung biopsy is an effective method for the diagnosis and differential diagnosis of spherical pneumonia.