单发结节肺结核与周围型肺癌的影像鉴别

新发传染病电子杂志 ›› 2018, Vol. 3 ›› Issue (4): 210-213.

单发结节肺结核与周围型肺癌的影像鉴别

黄早胜¹, 骆柘璜², 徐新华¹, 钱璐瑶¹

1.苏州大学附属常州肿瘤医院影像科,江苏常州 213032;
2.江西省人民医院PET/CT中心,南昌 330006

收稿日期:2018-09-12 出版日期:2018-11-30 发布日期:2020-07-09
通讯作者: 骆柘璜,Email：lzh6392@sina.com
基金资助:
江西省科技厅科技支撑项目（20142BBG70095）

Imaging differentiation of solitary tuberculosis and peripheral lung cancer

HUANG Zao-sheng¹, LUO Zhe-huang², XU Xin-hua¹, QIAN Lu-yao¹

1. Department of Radiology,Changzhou Cancer Hospital Affiliated to Soochow University, Jiangsu Changzhou 213032, China;
2. PET/CT Center of Jiangxi Provincial people's Hospital, Nanchang 330006, China

Received:2018-09-12 Online:2018-11-30 Published:2020-07-09

摘要/Abstract

摘要： 目的探讨肺结核单发结节与周围型肺癌的影像鉴别要点,提高肺结核单发结节与早期周围型肺癌的影像学鉴别诊断水平。方法回顾性分析经临床及手术病理证实的15例肺结核结节和24例周围型肺癌的CT影像资料,15例肺结核结节中,7例行胸部CT平扫,8例行胸部CT平扫+增强扫描,3例进行了18F-FDG PET/CT检查;24例肺癌中,4例行胸部CT平扫,20例行胸部CT平扫+增强扫描,2例进行了18F-FDG PET/CT检查,并对其CT及PET/CT征象进行综合分析。结果肺结核结节钙化、边缘光滑(7/15、4/15)高于周围型肺癌(1/24、0/24),(P<0.05、P<0.05)。肺结核结节分叶、毛刺及病灶强化>20HU(4/15、5/15、2/15)低于周围型肺癌(18/24、17/24、17/24),(P<0.05、P<0.05、P=0.001);肺结核结节与周围型肺癌在病灶直径、空洞、胸膜凹陷及肥厚二者无明显差异(P>0.05) 。结核结节SUVmax相对低于周围型肺癌, 二者无明显差异。结论肺结核结节与周围型肺癌的CT征象有一定的特征性,也存在部分交叉、重叠,合理联合应用PET/CT,对肺内单发结节肺结核与肺癌的鉴别诊断具有一定价值。

关键词: 结核, 肺癌, 体层摄影术/X线计算机, 正电子发射断层显像术

Abstract: Objective To study the differential imaging diagnosis of solitary tuberculosis and peripheral lung cancer.Methods CT images of 15 cases of tuberculosis and 24 cases of peripheral lung cancer confirmed by surgical pathology and clinical analysis were retrospectively analyzed. Among the 15 tuberculosis,7 cases had chest CT plain scans, 8 cases had chest CT plain scans and enhanced scans, and 3 cases were examined by 18F-FDG PET/CT. Among the 24 lung cancer cases, 4 cases had chest CT plain scans 20 cases had chest CT plain scans and enhanced scans and 2 cases were examined by 18F-FDG PET/CT. The CT and PET/CT signs were comprehensively analyzed. Results The probabilities of calcification and smooth edges among tuberculosis patients (7/15, 4/15) were higher than peripheral lung cancer patients (1/24, 0/24)(P<0.05、P<0.05). The probabilities of lobulation signs, speculation signs and enhancement>20HU among tuberculosis patients (4/15, 5/15, 2/15) were lower than peripheral lung cancer patients (18/24, 17/24, 17/24) (P<0.05、P<0.05、P=0.001).There were no significant differences in lesion diameters, cavities,and pleural indentation or thickening between tuberculosis patietns and peripheral lung cancer patients (P>0.05). The SUVmax of tuberculosis was lower than that of peripheral lung cancer, however, the differences were not significant. Conclusion CT signs of tuberculosis and peripheral lung cancer are characteristic, and some of them overlap. Reasonable combination of PET/CT is of great value for the diagnosis of tuberculosis and peripheral lung cancer.

Key words: Tuberculosis, Lung cancer, Tomography/X-ray computed, Positron emission tomography

黄早胜, 骆柘璜, 徐新华, 钱璐瑶. 单发结节肺结核与周围型肺癌的影像鉴别[J]. 新发传染病电子杂志, 2018, 3(4): 210-213.

HUANG Zao-sheng, LUO Zhe-huang, XU Xin-hua, QIAN Lu-yao. Imaging differentiation of solitary tuberculosis and peripheral lung cancer[J]. Electronic Journal of Emerging Infectious Diseases, 2018, 3(4): 210-213.

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