CT Diagnosis Of Cavitary Lung Diseases

Objective:To investigate the CT findings features of cavitary lung diseases so as to improve the diagnostic and differential accuracy of the diseases.Material and Methods:The CT findings future of 207 cases of cavitary lung diseases confirmed were retrospectively reviewed.Results:(1) The difference between the gender and age was found in different cavitary lung diseases(P＜0.05).The male/female incidence ratio of lung cancer,tuberculosis,inflammatory lung cavitary diseases was 1.6,2.2 and 3.3 respectively.The average age of lung cancer group was the highest(62±12 years old),fungal group and AIDS groups centered(respectively 39±17 and 38±8 years old),tuberculosis,pneumonia and lung metastasis group was the lowest (respectively 53±18,48±18 and 49±8 years old).The distribution was different in various multiple cavitary lung diseases.Local multiple onset was particularly prevalent in cavitary pulmonary tuberculosis,scattered multiple onset was particularly prevalent in various infected cavitary lung diseases,diffuse multiple onset was particularly seen in cavitary pulmonary metastases.(2) Lung cancer was found closely correlated with the following CT signs:the focus was located in low lung lobes,eccentric or irregular,thicked wall and rough inner wall,a mural nodule,lobulation and spiculation,localized pleural involvement,hilar and/or mediastinal lymph node enlargement(p＜0.05).(3) Pulmonary tuberculosis was found closely related to following CT signs:the focus was located in the upper lung lobes,the length was greater than 4cm,a long spiculation or cord,calcificated wall,satellite lesions appearment(p＜0.05). (4)Pulmonary cavity in AIDS was found usually located in lower lung lobes,was 2～4cm in length,had thicked wall,smooth inner wall,rough outer wall,halo sign,and hila and/or mediastinal lymph node(s) enlargement.Pulmonary cavity in AIDS had close correlation with the following CT signs:the focus was located in the lower lung lobes,the length was between 2cm and 4cm,eccentric or irregular,had air-fluid level inside the cavity,had halo sign and hila and/or mediastinal lymph node(s) enlargement(p＜0.05).(5) The enhanced CT value was found significantly lower in wall of cavitary lung tuberculosis than in the lung cancer,inflammatory lung cavity and lung metastases(P＜0.05),which was 16.8,32.2,28.7,29.4 HU respectively.(6) The morphology of the lesion and the cavity in it wound change variously during the treatment and follow-up in different kinds of cavitary lung diseases.Conclusions:(1) Morphological characteristics of CT play an important role in the diagnosis of cavitary lung diseases,but sometimes it is very difficult to identify the quality of cavitary lung diseases from the CT morphological characteristics of the cavity simply,the patient's gender has an important role.(2) Pulmonary cavity in AIDS is usually located in lower lung lobes,is 2～4cm in length,has thickened wall,smooth inner wall,rough outer wall,halo sign,and hila and/or mediastinal lymph node(s) enlargement.CT morphology have prompted role for the diagnosis of AIDS,but correct diagnosis should combined with clinical date.(3) CT follow-up can improve the capabilities of diagnosis and differential diagnosis for cavitary lung diseases, and it is important for early detection of complications,evaluation of treatment efficacy,and further guide treatment and prognosis evaluation.