标题：肺部癌性空洞与其他空洞的CT诊断及鉴别诊断

      作者：赵 林 1，李会菊 1，李晓阳 1，邢国凤 1，张德江 1，陈旭荣 1，杜雅君 2
    (唐山市人民医院CT室 1、神经内三科 2，河北 唐山 063001)

      卷次： 2015年26卷9期

      【摘要】 目的 探讨肺部癌性空洞和其他空洞的CT表现特点及其鉴别要点，提高各种疾病空洞的诊断
率。方法 选取本院就诊的81例伴有空洞的肺疾病患者，采用回顾性研究分析空洞发生的部位、大小、内容物、
壁厚度等指标进行统计分析。结果 该81例患者中，肺癌、肺结核、肺脓肿、干酪性肺结核、肺霉菌感染和肺囊肿
的空洞位于病灶中心的比例分别为 23.8% (10/42)、73.6% (14/19)、25% (2/8)、20% (1/5)、100% (5/5)和 50% (1/2)；
肺癌和肺结核空洞位置偏心的比率分别为76.2%和26.4%，差异具有统计学意义(P<0.05)；出现空洞部位上叶以
干酪性肺炎为最高，为80%，肺癌和肺脓肿部位下叶的比率分别为69.0%和12.5%，两者比较差异具有统计学意义
(P<0.05)。空洞平均直径的测量结果：肺癌和干酪性肺炎两者数值差异有统计学意义(P<0.05)，肺癌与其他类型
两两比较差异均无统计学意义(P>0.05)。壁CT强化幅度结果：肺癌与肺脓肿、肺癌与肺霉菌感染CT幅度比较差
异具有统计学意义(P<0.05)，肺癌与其他类型两两比较差异均无统计学意义(P>0.05)。 壁平均厚度结果：肺
癌、肺结核和肺脓肿的空洞壁平均厚度均比较高。肺癌与肺结核、肺脓肿进行两两比较差异均无统计学意义
(P>0.05)。结论 肺部空洞性病变的发生部位、空洞壁的厚度及形态对鉴别伴肺癌空洞与其他肺疾病空洞具有
诊断意义。

      【关键词】 电子计算机体层摄影；空洞；肺疾病

      【中图分类号】 R445 【文献标识码】 A 【文章编号】 1003—6350（2015）09—1295—04


CT diagnosis and differential diagnosis of carcinomatous cavity of lung and other cavities.
ZHAO Lin 1, LI Hui-ju 1,
LI Xiao-yang 1, XING Guo-feng 1, ZHANG De-jiang 1, CHEN Xu-rong 1, DU Ya-jun 2. CR Room 1, the Third Department
of Neurology 2, People's Hospital of Tangshan City, Tangshan 063001, Hebei, CHINA

【Abstract】 Objective To identify the key CT features and differential characteristics of carcinomatous cavi-
ty of lung and other cavities, and to improve the diagnosis rate of the cavities. Methods Eighty-one patients of pul-
monary diseases with cavities in our hospital were selected and retrospectively analyzed. The site, size, content, thick-
ness and other indexes of cavity were analyzed. Results In the 81 patients, the rate of cavity in the center of lesion
for pulmonary carcinoma, tuberculosis, pulmonary abscess, caseous pneumonia, pulmonary fungal infection and pul-
monary cyst were 23.8% (10/42), 73.6% (14/19), 25% (2/8), 20% (1/5), 100% (5/5) and 50% (1/2), respectively. The
rate of cavity not in the center of lesion for pulmonary carcinoma, tuberculosis were 76.2% and 26.4%, respectively,
and there was a significant difference (P<0.05). The rate of cavity in the upper lobe was the highest for caseous pneu-
monia (80%), And the rate in the lower lobe were 69.0% and 12.5% for pulmonary carcinoma and pulmonary abscess,
respectively, with statistically significant difference (P<0.05). In terms of average diameter of cavity, there was signifi-
cant difference between pulmonary carcinoma and caseous pneumonia (P<0.05), but not between pulmonary carcino-
ma and other pulmonary diseases (P>0.05). For the amplitude of CT, significant differences were found between pul-
monary carcinoma and pulmonary abscess, pulmonary carcinoma and pulmonary fungal infection (P<0.05), but not be-
tween pulmonary carcinoma and other pulmonary diseases (P>0.05). The average wall thickness of cavity was relative-
ly high in pulmonary carcinoma, pulmonary tuberculosis and pulmonary abscess, with no statistically significant differ-
ence between any two of the three (P>0.05). Conclusion The site, wall thickness and shape of the pulmonary cavity
show great significance in the differential diagnosis of carcinomatous cavity and other cavities.