全科医学临床与教育2023年10月第21卷第10期ClinicalEducationofGeneralPracticeOct.2023,Vol.21,No.10DOI:10.13558/j.cnki.issn1672-3686.2023.010.007基金项目:嘉兴市级课题(2021AD30135)作者单位:314000浙江嘉兴,浙江省中医药大学附属嘉兴市中医医院放射科·论著·局灶性机化性肺炎的CT征象与病理对照分析陈佳王海亮顾吾立[摘要]目的分析局灶性机化性肺炎的CT征象,提高其影像学诊断的正确性。方法回顾性分析30例经手术或穿刺活检病理证实为局灶性机化性肺炎的CT表现。结果病例均为单发,右肺18例、左肺12例,其中11例位于胸膜下,呈宽基底与胸膜紧贴。病灶呈类圆形结节样9例、楔形13例、不规则形8例;边缘有长毛刺5例,边缘锯齿样改变6例。密度均匀7例、混杂密度23例。病灶边界清晰4例,边缘模糊17例,胸膜粘连增厚12例,胸膜凹陷3例,周围纤维条索影5例,支气管血管集束征4例,伴有少量胸腔积液4例。27例行增强检查,均匀明显强化5例,明显不均匀强化13例,环形强化2例,轻度强化5例,强化不明显2例。结论大部分的局灶性机化性肺炎CT征象具有一定特异性,经过综合分析可以明确诊断,但有些CT征象与肺癌等其他有所重叠,则需要借助病理检查。[关键词]局灶性机化性肺炎;体层摄影术;X线计算机ComparativeanalysisofCTsignsandpathologyoffocalorganizingpneumoniaCHENJia,WANGHailiang,GUWuli.DepartmentofRadiology,ZhejiangChineseMedicalUniversityAffiliatedJiaxingTCMHospital,Jiaxing314000,China.[Abstract]ObjectiveToanalyzetheCTsignsoffocalorganizingpneumoniaandimprovetheaccuracyofimagingdi⁃agnosis.MethodsTheCTfindingsof30casesoffocalorganizedpneumoniaconfirmedbyoperationorpuncturebiopsywereanalyzedretrospectively.ResultsAllthecasesweresolitary,including18casesofrightlungand12casesofleftlung,ofwhich11caseswerelocatedunderthepleuraandthebroadbasewasclosetothepleura.Thelesionswereroundnodularin9cases,wedgein13cases,irregularin8cases,longburrin5casesandserratedin6cases.Thedensitywasuniformin7casesandmixeddensityin23cases.Theboundaryofthefocuswasclearin4cases,blurrededgein17cas⁃es,pleuraladhesionthickeningin12cases,pleuraldepressionin3cases,peripheralfibrouscordshadowin5cases,bronchovascularconvergencesignin4cases,andasmallamountofpleuraleff...