肺内机化性肺炎结节与周围性肺癌结节的ct诊断及鉴别诊郭晓艳渭南市屮心医院CT室陕西渭南714000作者简介:郭晓艳,77年8月，毕业西安交通大学医学部，渭南市屮心医院ct室，主治医师.【摘要】目的探讨采用多层螺旋CT对肺内局灶性机化性肺炎与周围型肺癌结节进行诊断和鉴别诊断的临床价值.方法选取40例经手术后组织病理学或穿刺活检病理检查确诊的周围型肺癌患者作为恶性组,30例经穿刺活检证实为局灶性机化性肺炎的患者作为良性组，对恶性组患者术前的CT检查资料及良性组患者的CT资料进行整理分析，对两组患者的CT表现进行比较，并以病理结果作为金标准，判断多层螺旋CT鉴别诊断周围型肺癌的临床价值.结果恶性组的血管集束征(80%)、支气管充气征(42.5%)、分叶征(90.00%)、细短毛刺征(67.50%),胸膜凹陷征(45.00%)均显著的高于良性病变组患者的(6.67%),支气管充气征(20.00%)、分叶征(16.67%)、细短毛刺征(20.00%),胸膜凹陷征(13.33%)且差异具有统计学意义(P<0.05良性组的粗长毛刺征(70%)、空泡征(83.33°%)、钙化征(46.67%),棘状突起(86.67°%)均显著的高于恶性组粗长毛刺征(17.50%)、空泡征(10.00%)、钙化征(15.00%)、棘状突起(32.50%)且差异具有统计学意义(P<0.05).多层螺旋CT鉴别诊断周围型肺癌恶性结节与的肺闪局灶性机化性肺炎的灵敏度:85%，特异度:76.67%，漏诊率：15%，误诊率:23.33%，阳性预测值:82.93°%，阴性预测值:79.31%.结论肺内局灶性机化性肺炎与周围型肺癌结节的多层螺旋CT检查K影像学表现存在显著的差异，根据这些影像学特征表现差异，多层螺旋CT多肺內局灶性机化性肺炎与周围型肺癌结节具有一定的鉴别诊断能力.【关键词】多层螺旋CT;肺内局灶性机化性肺炎；周围型肺癌结节；鉴别诊断[Abstract]objectivetoinvestigatetheMDCTfocalmachineischangedwithinthelungpneumoniawithperipherallungnodulesintheclinicalvalueofdiagGnosisanddifferentialdiagnosis.Methodstochoose40caseshandledpostoperativehistopathologyorbiopsypathologicalexaminationdiagnosisofperipherallungcancerpatientsasmalignantgroup,30casesconfirmedbybiopsyforfocalpneumoniapatientsasbenigngroup,preoperativeCTexaminationdataofthepatientswithmalignantgroupandbenigngroupofpatientswithCTdata,CTperformancecomparisonoftwogroupsofpatients,andasthegoldstandardbypathologicalresultsjudgmentofmultisliceCTdifferentialdiagnosisofperipherallungcancerclinicalvalue.Resultsmalignantvascularclustergroup(80%),characters(42.5%),air——filledbronchiYeZheng(90.00%),fineshortburrsign(67.50%),pleuralindentationsign(45.00%)weresignificantlyhigherthanthatofbenignleGsionsofthepatients(6.67%),air—filledbronchisign(20.00%),pointsYeZheng(16.67%),fineshortburrsign(20.00%^pleuralindentationsignf13.33%)a(ndthedifferenceisstatisticallysignificant(P<0.05)•Benigngroupofthicklongburr(70%),cavitation)classifiers(83.33%),calcification(46.67%),spines86.67%)weresignificantlyhigherthaninmalignantgroupthicklongburrsign(17.50%)zcavitation)classifiers(10.00%),calcification(15.00%),spines(32.50%),andthedifferenceisstatisticallysignificant(P<0.05)•MultisliceCTdifferentialdiagnosisofperipherallungcancer,malignantnodulesandlunginfocalpneumoniaofsensitivity:85%,specialityrate:76.67%,themisseddiagnosis:15%/themisdiagnosisrate:23.33%,positivepredictivevalue:82.93%,negativepredictivevalue:79.31ConclusionthelungsfocalmachinepneumoniawithperipherallungnodulesofmultisliceCTexaminationundertheimagingfindingsofremarkabledifferences,accordingtotheimagingcharacteristicsofdifference'MDCTIungsmorefocalmachinepneumoniaandthedifferentialdiagnosisofperiphGerallu【Knegynwoodrudlses】haveacertainability.MDCT;Thelungsfocalmachinepneumonia;Peripherallungnodules;Thedifferentialdiagnosis【中图分类号】R7...