Multi-slice Spiral CT in Diagnosis of Lung Lesions with Cross Interlobar Fissure Symptom / 中国医学影像学杂志

ABSTRACT

Purpose To explore multi-slice spiral CT (MSCT) features of lesions with cross interlobar fissure symptom in the lung,and through pathological results,to study the differential diagnosis significance of cross interlobar fissure symptom.Materials and Methods Forty-nine patients who were confirmed with lesions in the lung with cross interlobar fissure symptom through surgery,pathological certification or clinical diagnosis from October,2015 to October,2016 were collected.Retrospective analysis was conducted on cross interlobar fissure symptom lesions and other representation in the lung on CT image.Results Sixteen cases were multiple lesions and 33 cases of single cross interlobar fissure lesions.9 cases in the multiple lesions (56.3％) were contagious lesions,including tubercle bacillus,fungus,staphylococcus aureus and klebsiella pneumoniae infection,in which 3 cases (18.7％) were adenocarcinoma,2 cases (12.5％) metastasis,1 case (6.3％) Wegener's granulomatosis and 1 case (6.3％) antineutrophil cytoplasmic anti-body (ANCA) related vasculitis.21 cases in single lesions (63.6％) had malignant tumor,including adenocarcinoma of lung,squamous carcinoma,lymphoma and metastasis,in which 6 cases (18.2％) were sclerosing pneumocytoma or hamartoma with smooth verge and without malignant symptom,and another 6 cases (18.2％) were inflammatory lesions.Conclusion Symptoms of lesions in the lung with cross interlobar fissure growth can be seen in malignant tumor,benign tumor and inflammatory lesions.Multiple lesions are accompanied with cross interlobar symptom which can be seen more often in benign lesions,but also can be seen in malignant tumor (metastasis and intrapulmonary metastasis of lung cancer).Single lesions are also accompanied with cross interlobar symptom which can be seen more often in malignant tumor,but also can be seen in cryptogenic organizing pneumonia and benign tumor.Sometimes,it's very difficult to identify malignant tumor with single cross interlobar distributed cryptogenic organizing pneumonia.When features of benign tumor are very clear,possibility of sclerosing pneumocytoma or hamartoma shall be taken into consideration.