摘要
Abstract
Objective To investigate the CT manifestations of solitary localized spherical pneumonia(SLSP)and its differential diagnostic value in order to improve the imaging diagnostic ability of the disease. Methods From August 2006 to January 2015,we collected the clinical data of 54 patients who were diagnosed as SLSP by surgery and pathology and accorded with inclusion and exclusion criteria from Kailuan Tangjiazhuang Hospital. CT manifestations of patients were observed and analyzed,including site,shape,margin,size,density,adjacent pleura changes,manifestations close to the hilus of lung, manifestations of the field adjacent to nidus. The dynamic changes after anti - inflammation therapy were also observed and analyzed. Results There were 38(70. 4% )patients who had nidus in the posterior basal segments and dorsal segments of the lower lobes;46(85. 2% )patients had wedge - shape nidus,including 34(73. 9% )patients with square - like nidus,9 (19. 6% )patients with hill - shape nidus and 3(6. 5% )patients with triangle - shape nidus. There were 41(75. 9% )patients who had coarse and long burrs and 13(24. 1% )patients who had vague ribbon - like low - density shadow which took on halo sign. The diameter of nidus was 2. 0 - 7. 5 cm,and the average diameter was 3. 9 cm. The density of nidus of 30(55. 6% ) patients was average. There were 48(88. 9% )patients who had nidus close to pleura,and 41 patients had even increase in the thickness of surrounding pleura. Localized hyperemia sign appeared in 30(55. 6% )patients,and 17(31. 5% )patients had slight increase in the bronchial wall corresponding to lesion;20(37. 0% )patients had small patchy oozing focus. There were 49 (90. 7% )patients who received anti - inflammation therapy;among them,47(95. 9% )patients saw symptoms relieve and disappear after anti - inflammation therapy,2 ( 4. 1% )patients had unfavorable treatment outcomes after antituberculosis therapy and then received anti - inflammation therapy which dissipated and absorbed nidi,and 5(9. 3% )patients received excision. Conclusion SLSP mainly locates in the lateral posterior basal segments and dorsal segments of the lower lobes,mostly being close to pleural surface and taking on the wedge or quasi - circular shape;the margins are mostly coarse long burrs or vague halo signs. Localized hyperemia signs appear in vessels and bronchia at the hilus of the lung,and small patchy inflammatory exudation appear. Patients with SLSP close to pleural surface are mostly with average increase in the thickness of pleura in a wider range. Combined with clinical and laboratory manifestations and observation of the dynamic changes of nidus,SLSP can be definitely diagnosed,and aspiration biopsy or thoracotomy can be conducted when there is difficulty in diagnosis.关键词
肺炎/单发局灶/体层摄影术/诊断,鉴别Key words
Pneumonia/Solitary localized nidus/Tomography/Diagnosis,differential分类
医药卫生
