【摘要】 目的探讨CT扫描鉴别诊断马红球菌肺脓肿与肺部空洞病变的价值。方法马红球肺脓肿患者16例,肺结核性厚壁空洞患者12例,肺癌性空洞患者7例,行胸部CT常规平扫及增强扫描,对平扫、增强30 s、60 s CT值进行比较分析。结果 16例马红球菌肺脓肿患者中,多发空洞11例,单发空洞5例;增强CT扫描空洞壁造影剂浓度呈速升速降变化。12例结核性厚壁空洞患者,多发空洞5例,单发空洞7例;增强CT扫描空洞壁造影剂浓度呈速升速缓降变化。7例癌性空洞患者均为单发空洞,增强CT扫描空洞壁造影剂浓度呈速升缓降变化。结核空洞组的平扫CT值、增强30 s CT值、增强60 s CT值均高于马红球菌肺脓肿组、癌性空洞组(P<0.05);而马红球菌肺脓肿组与肺癌性空洞壁组的平扫CT值、增强30 s CT值、增强60 s CT值比较,差异无统计学意义(P>0.05)。结论 CT平扫、动态增强扫描对马红球菌肺脓肿、肺结核空洞、空洞型肺癌的鉴别诊断有一定临床价值。更多还原

【Abstract】 Objective To evaluate the value of CT scan in the differential diagnosis of Rhodococcus equi pulmonary abscess and cavitary pulmonary lesions. Methods Routine chest CT scan and enhanced CT scan were performed among 16 patients with Rhodococcus equi pulmonary abscess,12 patients with tuberculous thick-wall cavity and 7 patients with lung cancerous cavity. A comparative analysis on the values of their routine CT scan,30s- and 60s-enhanced CT scan was conducted. Results There were 11 cases of multiple cavity and 5cases of single cavity among 16 cases of Rhodococcus equi pulmonary abscess,and enhanced CT scan showed a rapid increase and rapid decrease in the concentration of cavity-wall contrast medium. There were 5 cases of multiple cavity and 7 cases of single cavity among 12 cases of tuberculous thick-wall cavity,and enhanced CT scan showed a rapid increase and slow decrease in the concentration of cavity-wall contrast medium. All of the 7 patients with cancerous cavity were single cavity,and enhanced CT scan showed a rapid increase and slow decrease in the concentration of cavity-wall contrast medium. The values of routine CT scan,30s- and 60s-enhanced CT scan were higher in the tuberculous cavity group compared with Rhodococcus equi pulmonary abscess group and lung cancerous cavity group( P < 0. 05),which showed no significant difference between Rhodococcus equi pulmonary abscess group and lung cancerous cavity group( P > 0. 05).Conclusion Routine CT scan and dynamic enhanced CT scan are of certain clinical value in the differential diagnosis of Rhodococcus equi pulmonary abscess,tuberculous cavity and cavitary lung cancer.更多还原