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目的 :探讨大量胸水并肺癌的CT征象 ,提高诊断正确率。材料与方法 :对 33例经病理证实为肺癌病人的CT资料进行回顾性分析 ,患者均为大量的胸水并肺组织受压不张 ,肿瘤又位于不张的肺内 ,对CT征象及与其它影像学检查的诊断率进行了对比分析。结果 :CT和MRI诊断率在 80 %左右 ,X线平片及B超在 2 0 %左右 ,二者比较差异有高度显著性 (P≤0 0 1)。肺不张的异常改变包括形态、密度、支气管的改变。胸膜改变仅 2 0 % ,肺门及纵隔侵犯为 5 8% ,两者间差异有显著性(0 5 >P≥ 0 0 5 )。结论 :(1)大量胸水并肺癌的影像学检查首选CT ;(2 )不张肺的形态、密度、支气管的异常对诊断起重要作用 ,可使诊断率达到 85 % ;(3)纵隔、肺门侵犯有辅助诊断作用 ,而胸膜改变发生率较低 ,无特异性。
Objective: To explore the CT signs of a large number of pleural effusion and lung cancer and improve the diagnostic accuracy. Materials and Methods: A retrospective analysis was performed on the CT data of 33 patients with pathologically confirmed lung cancer. All of them were pleural effusion with pulmonary atelectasis and the tumor located in the atelectasis lung. The diagnostic rate of imaging examination were compared. Results: The diagnostic rates of CT and MRI were about 80%. The X-ray plain films and B-ultrasound were about 20%. The difference between them was highly significant (P≤0 0 1). Abnormal changes in atelectasis include morphology, density, and bronchial changes. Pleural changes only 20%, hilar and mediastinal invasion was 58%, the difference between the two was significant (0 5> P 0 05). (2) The morphology, density and bronchial abnormality of atelectasis have an important role in the diagnosis, which can make the diagnosis rate up to 85%; (3) The mediastinal and pulmonary Door invasion has aided diagnosis, and the incidence of pleural changes lower, non-specific.