本文關(guān)鍵詞： 肺癌 機(jī)化性肺炎 CT(計(jì)算機(jī)斷層掃描) 毛刺　出處：《延邊大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討機(jī)化性肺炎(organizing pneumonia,OP)與肺癌的影像學(xué)特征,提高CT對機(jī)化性肺炎和肺癌的鑒別診斷價(jià)值。資料和方法:回顧性研究8例已經(jīng)進(jìn)行病理檢查證實(shí)的OP患者,隨機(jī)選擇31例肺癌患者作為對照組。比較兩組臨床特征、CT表現(xiàn)及病變強(qiáng)化模式。本次研究已通過延邊大學(xué)附屬醫(yī)院倫理委員會批準(zhǔn)�；颊咧饕R床表現(xiàn)為咳嗽、咳痰、咯血、胸痛、氣促、發(fā)熱等,本研究主要集中在CT表現(xiàn)的對比分析。通過兩獨(dú)立樣本t檢驗(yàn)和卡方(χ2)檢驗(yàn)比較兩組的結(jié)果。P0.05表示差異具有統(tǒng)計(jì)學(xué)意義。以下為觀察的CT特征:位置、分布、大小、支氣管、毛刺、腔洞、壞死,增強(qiáng)、鈣化、磨玻璃影、支氣管血管影、支氣管擴(kuò)張、結(jié)節(jié)影、淋巴結(jié)。結(jié)果:肺癌組共31例,其中男性18例,女性13例。年齡41～82歲,平均年齡(63.42±10.69)歲。左肺10例,占32.3%,其中左肺上葉5例,左肺下葉3例,左肺門2例。右肺21例,占67.7%,右肺上葉10例,右肺中葉3例,右肺下葉5例,右肺門3例。病變主要分布在中央21例,占67.7%,周圍10例,占32.3%。病灶的大小范圍1.7～11cm,平均大小為4.98±2.12cm。在CT的腫塊病變有毛刺11例,占35.5%,異常支氣管24例,占77.4%(1例支氣管擴(kuò)張、10例支氣管狹窄、13例阻塞支氣管),空洞8例,占25.8%,壞死4例,占12.9%,動脈期凈增強(qiáng)CT值28.4HU,靜脈期凈增強(qiáng)CT值25.1HU。局部周邊的CT改變?yōu)槟ゲＡв?6例,占51.6%,支氣管血管周圍磨玻璃影18例,占58.1%,支氣管擴(kuò)張3例,占9.7%,結(jié)節(jié)影17例,占54.8%,淋巴腫大24例,占77.4%。機(jī)化性肺炎組共8例,其中男性7例,女性1例。年齡35～75歲,平均年齡(51.38±12.83)歲。左肺2例,占25%,均位于左肺下葉。右肺6例,占75%,其中右肺上葉2例,右肺中葉2例,右肺下葉2例。全部病變發(fā)生于周圍8例,占100%。病灶的大小范圍為1.3～6cm,平均大小3.33土 1.64cm。在CT的腫塊病變有毛刺0例,異常支氣管2例,占25%(1例支氣管狹窄、1例阻塞支氣管),空洞3例,占37.5%,壞死1例,占12.5%,動脈期凈增強(qiáng)CT值23.2HU,靜脈期動脈凈增強(qiáng)CT值36HU。局部周邊的CT改變?yōu)槟ゲＡв?例,占12.5%,支氣管擴(kuò)張1例,占12.5%,淋巴腫大2例,占25%。通過臨床資料和CT表現(xiàn)在兩組病例中進(jìn)行比較分析,我們發(fā)現(xiàn)肺癌組平均年齡(63.42±10.69)歲,明顯高于機(jī)化性肺炎組(51.38 士 12.83)歲,且有統(tǒng)計(jì)學(xué)意義(P0.05)。咳嗽、毛刺、磨玻璃影、支氣管血管周圍磨玻璃影、結(jié)節(jié)影和淋巴結(jié)在肺癌組明顯高于機(jī)化性肺炎組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。同時(shí)機(jī)化性肺炎組呼吸困難、胸痛及靜脈期造影增強(qiáng)高于肺癌組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。其他CT表現(xiàn)均無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:對局灶性機(jī)化性肺炎及肺癌的CT表現(xiàn)、分布及臨床特點(diǎn)的詳細(xì)分析有助于分辯兩者的鑒別診斷
[Abstract]:Objective: to investigate the imaging features of organizing pneumonia-opp and lung cancer, and to improve the value of CT in differential diagnosis of organic pneumonia and lung cancer. Data and methods: a retrospective study of 8 patients with op confirmed by pathological examination was made. Thirty-one patients with lung cancer were randomly selected as the control group. The clinical features of the two groups were compared with CT findings and enhancement models. This study was approved by the Ethics Committee of the affiliated Hospital of Yanbian University. The main clinical manifestations of the patients were cough, expectoration and hemoptysis. Chest pain, shortness of breath, fever and so on. This study mainly focuses on the comparative analysis of CT findings. The results of the two groups were compared by t-test of two independent samples and chi-square (蠂 ~ 2) test. Distribution, size, bronchus, burr, cavity, necrosis, enhancement, calcification, vitreous shadow, bronchovascular shadow, bronchiectasis, nodular shadow, lymph node. 13 cases were female. The average age was 63.42 鹵10.69 years old. There were 10 cases of left lung, including 5 cases of left upper lobe, 3 cases of left lower lobe, 2 cases of left hilum, 21 cases of right lung (67.7%), 10 cases of upper lobe of right lung, 3 cases of middle lobe of right lung and 5 cases of lower lobe of right lung. Right hilum was found in 3 cases. The lesions were mainly distributed in the center of 21 cases (67.7%), around 10 cases (32.3cm). The size of the lesions was 1.711cm, the average size was 4.98 鹵2.12cm.There were 11 cases of burr in CT, accounting for 35.5cm, and 24 cases of abnormal bronchus. One case of bronchiectasis, 10 cases of bronchiectasis, 10 cases of bronchial stenosis, 13 cases of obstruction of bronchus, 8 cases of cavity (25.8%), 4 cases of necrosis (12.9%), 28.4 HUU in arterial phase and 25.1HU in venous phase. The local peripheral CT changes were glassy shadow in 16 cases. There were 18 cases of bronchiectasis (58.1%), 3 cases of bronchiectasis (9.7%), 17 cases of nodular shadow (54.8%), 24 cases of lymphoid enlargement (77.4%). The mean age was 51.38 鹵12.83 years old. There were 2 cases of left lung, 25 cases of right lung, and 6 cases of right lung, including 2 cases of upper lobe of right lung, 2 cases of middle lobe of right lung and 2 cases of lower lobe of right lung. The size of the lesion was 1.3 ~ 6 cm, with an average size of 3.33 鹵1.64 cm. In CT, there were burrs in 0 cases, abnormal bronchus in 2 cases, and bronchial stenosis in 1 case (1 case), cavity in 3 cases (37.5%) and necrosis in 1 case. The CT value was 23.2HUU in arterial phase and 36HU in venous phase. The local peripheral CT changes were glassy shadow in 1 case (12.5%), bronchiectasis in 1 case (12.5%), lymphomegaly in 2 cases, bronchiectasis in 1 case, and lymphomegaly in 2 cases. The average age of lung cancer group was 63.42 鹵10.69 years old, which was significantly higher than that of organic pneumonia group (51.38 鹵12.83) years. The peribronchovascular opacity, nodular shadow and lymph nodes were significantly higher in lung cancer group than in lung cancer group (P 0.05). At the same time, the patients with organized pneumonia had difficulty breathing, chest pain and venography were higher than those in lung cancer group. The difference was statistically significant (P 0.05). There was no significant difference in other CT findings. Conclusion: the detailed analysis of CT manifestations, distribution and clinical characteristics of focal organized pneumonia and lung cancer is helpful to distinguish the differential diagnosis between the two.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R734.2;R730.44;R563.1
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本文編號：1511288