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The Differential Diagnosis in Diffuse Nodular Lung Diseases on HRCT

Author: NingFengGang
Tutor: ZhouXinHua
School: Beijing Tuberculosis and Thoracic Tumor Research Institute
Course: Internal Medicine
Keywords: Tuberculosis Interlobular septa Hematogenous spread Hematogenous metastasis Lymph node metastasis Bronchiectasis Pulmonary lobule Sarcoidosis Disseminated Vascular bundle
CLC: R816.4
Type: Master's thesis
Year: 2007
Downloads: 197
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Abstract


Objective: To investigate the characteristics of abnormal lung lobular structure and other abnormal CT signs showed diffuse nodular lesions of tuberculosis and lung cancer diagnosis and differential value. Materials and Methods: 150 cases of tuberculosis, lung CT examination images with high-resolution reconstruction, of which 36 cases 0.625mm collimation multislice CT scan parallel MPR, MIP image reconstruction, 12 cases of CT-guided diffuse lung lesions biopsy. All cases were confirmed by bacteriology or pathology, clinical comprehensive diagnosis confirmed. Results: (1) pulmonary lymph node metastases lobular interval the anomaly appears beaded by 60% (9/15), and irregular shaped by 40% (6/15), hematogenous disseminated tuberculosis more performance for the interlobular septa knot nodular changes, the difference between statistical significance (P lt; 0.05). In the lobular real thin line, reticular opacities performance, pulmonary lymph node metastases, 60% (9/15), with hematogenous disseminated tuberculosis (6.3%, 5/79), pulmonary hematogenous metastases (6.7%, 2 / 30) and the difference between diffuse nodular bronchioloalveolar carcinoma (7.1%, 1/14) was significantly (P lt; 0.05). 83.3% (10/12) bronchial disseminated tuberculosis showed centrilobular tree bud, the diffuse nodular distinct hematogenous disseminated tuberculosis and lung cancer. Acute hematogenous disseminated pulmonary tuberculosis nodule size, density and distribution is mostly uniform. The majority of lung metastasis of blood cancer and subacute, chronic hematogenous disseminated pulmonary tuberculosis nodule sizes, part of the performance as nodular density and uneven distribution. Widely nodules more common in subpleural lung hematogenous metastases (50%, 15/30), lung cancer lymph node metastasis (86.7%, 13/15) and acute hematogenous disseminated pulmonary tuberculosis (66.2%, 43/65). Lung lymph node metastasis of cancer mediastinal lymph node enlargement and pleural effusion are common, respectively, 60% and 53.3%, respectively, with the the acute hematogenous disseminated tuberculosis (26.2%, 21.5%) difference was significant (P lt; 0.05). (2) MPR, MIP reconstruction images of lung lobular, nodular morphology and distribution of nodules in the lobular level display the satisfaction volumetric reconstruction of high-resolution images (VHRCT) no significant difference (P gt; 0.05). MIP reconstruction image better show nodules with blood vessels and the relationship between the two. Conclusion: the pulmonary lobule structural abnormalities of the characteristics and nodular morphology, distribution, and other important value accompanied by signs of diffuse nodular pulmonary tuberculosis, lung cancer diagnosis and differential. Control study of CT biopsy can further raise awareness of the HRCT images of diffuse nodular lesions. MPR, MIP reconstructed image can be displayed from different angles lesion morphology and distribution of the axial HRCT important supplementary means.

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CLC: > Medicine, health > Of Medical > Radiation Medicine > Each location and course of disease X - ray diagnosis and therapy > Chest and respiratory system
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