Analysis Of CT Signs And Clinical Data Of Solitary Pulmonary Cavity

Objective:This project was based on a retrospectively study of the radiological signs and clinical data of solitary pulmonary cavity disease.The aim was to improve the level of diagnosis and differential diagnosis,guid e early treatment and improve the prognosis of solitary pulmonary cavity disease.Materials and methods:The pulmonary radiological and clinical data of all isolated pulmonary cavity cases diagnosed explicitly in the first affiliated Hospital of Chengdu Medical College from March 2016 to April 2019 were collected,and sorted out and analyzed by SPSS 25.0 Statistics Software.Result:A total of 185 cases of solitary pulmonary cavity were included in the study.There were 87 cases of pulmonary tuberculosis cavity,41 cases of pulmonary carcinoma cavity,27 cases of pulmonary abscess cavity,19 cases of necrotizing pneumonia cavity,6 cases of invasive pulmonary fungal cavity,and 4 cases of pulmonary inflammatory pseudotumor cavity,and one case of pulmonary metastasis cavity.1.General data: The average age difference of isolated pulmonary cavity disease in each group was statistically significant.While,there was no significant difference in gender among the gr oups.The difference of ALB in among groups was statistically significant.The incidence of hypoproteinemia in acute infectious diseases such as pulmonary abscess and invasive pulmonary fungal disease was higher than that in chronic consumptive diseases su ch as tuberculosis.There was no significant difference in BMI among the groups.2.Radiological data:(1)The pulmonary tuberculosis cavities were mainly distributed in posterior segment of upper lobe and superior segment of lower lobe of both lungs.Mos t of the cavities were irregular,smooth inner wall,and common calcification of the cavity wall.Bronchial dissemination lesions and satellite lesions were specific CT signs of pulmonary tuberculosis.(2)The pulmonary carcinoma was mostly eccentric cavit y,with irregular shape,rough inner walls,and often accompanied by enlarged lymph nodes.The lobular sign,spiculation sign,mural nodule,bronchovascular convergence sign and bronchus truncation sign were specific CT signs of pulmonary carcinoma.(3)The CT signs of pulmonary fungal cavities were mainly intraglobular signs and air semilunar signs.(4)The pulmonary inflammatory cavities were mainly central cavities,and GGO and patchy infiltrates were common around the cavity wall.Air-liquid plane and pleural effusion were specific CT signs of pneumonia.(5)There was no significant difference in the distribution of wall thickness among different groups of solitary pulmonary cavity diseases according to the standard of 3mm;While the difference of the distribution of wall thickness between malignant and benign cavity according to the standard of 5mm and 15 mm was statistically significant.In the study,65.9% of carcinomatous cavities had a wall thickness of more than 15 mm,while 35.4% of non-carcinomatous cavities had a wall thickness of more than 15 mm.3.Clinical data:(1)The diagnostic sensitivity and specificity of T-SPOT.TB in tuberculosis cavities were 88.1% and 69.2%,respectively.(2)The diagnostic sensitivities of CEA and CYFRA21-1 in pulmonary carcinoma cavities were 50.0% and 47.4% respectively,the specificities were 89.5% and 89.5%,respectively.while the difference between groups in NSE positive rates was not statistically significant.(3)The sensitivity and specificity of G test in diagnosing invasive pulmonary fungal disease were 75.0% and 100.0%.while the difference between groups in positive rate of GM test was not statistically significant.(4)The diagnostic sensitivities of WBC,NE%,PCT,ESR,and CRP in pulmonary inflammatory cavities were 60.6%,72.7%,57.6%,93.9%,and 90.9% respectively,and the specificities were 89.4%,86.4%,92.4%,24.2%,and 28.7%,respectively.4.Conjoint analysis results:(1)Compared with single diagnosis test,the specificity of tuberculosis specific CT signs and T-SPOT.TB in serial diagnosis test increased(96.2%),and the sensitivity of parallel diagnosis test increased(97.6%).(2)Compared with single diagnosis test,the specificity of serial diagnosis test for pulmonary carcinoma specific C T signs and pulmonary carcinoma markers increased(93.0%),and the sensitivity of parallel diagnosis test increased(81.6%).(3)Compared with single diagnosis test,the specificity of serial diagnosis test of invasive pulmonary fungal disease specific CT signs and the G test increased(100.0%),and the sensitivity of parallel diagnosis test increased(100.0%),its specificity was 95.0%.(4)Compared with single diagnosis test,the specificity of serial diagnosis test for pulmonary inflammatory disease specific CT signs and infection markers such as PCT,WBC,and NE% increased(100.0%),and the sensitivity of parallel diagnosis test increased(97.0%).Conclusion:1.The age difference was helpful for the differential diagnosis of solitary pulmonary cavity disease,while the difference of gender distribution had no clinical value for diagnosis.The level of ALB had certain guiding significance for the determination of acute and chronic solitary cavity diseases.BMI had no clinical significance in dete rmining the nature of solitary pulmonary cavity disease.2.The method of dividing wall thickness with 5mm and 15 mm boundaries had clinical significance for the preliminary determination of solitary pulmonary cavity disease properties,and its clinical value was better than the method of dividing wall thickness with 3mm boundaries.3.The conjoint analysis of radiological and clinical data of patients with solitary pulmonary cavity disease c ould significantly improve the level of diagnosis and differential diagnosis of pulmonary cavity,and reduce the rate of misdiagnosis and missed diagnosis.It had great significance for the prognosis of solitary pulmonary cavity disease.