目的 探析非典型胸部结节病 患者的CT影像学表现及CT检查在该病临 床鉴别与诊断中的应用价值。方法 以 我院2012年5月-2015年5月收治的73例 胸肺部病变患者作为研究对象进行，均 以组织病理学检查结果作为最终结果， 所有患者均行多层螺旋CT扫描。总结非 典型胸部结节病患者的CT影像学表现， 并将确诊结果与组织病理学检查结果进 行对比，以明确CT的鉴别、诊断价值。 结果 非典型胸部结节病患者的CT影像学 主要表现为胸内淋巴结肿大，多出现磨 玻璃影、结节影、不规则索条影等肺部 浸润表现，伴斑点状钙化，增大淋巴结 界限清楚，呈明显均匀强化。共诊断出 58例非典型胸部结节、2例结核、2例淋 巴瘤、1例转移瘤，其余10例发生误诊或 漏诊，非典型胸部结节的诊断准确率达 86.6%（58/67）。非典型胸部结节病患 者CT强化方式以均匀为主，达65.7%，转 移瘤CT强化方式也为均匀强化，需予以 鉴别；非典型胸部结节病患者CT强化程 度多为明显强化，达64.2%，而结核、淋 巴瘤、转移瘤等一般不出现明显强化， 较好辨别。结论 CT在非典型胸部结节病 患者中的应用可更清楚观察病变，利于 结节病病变的定位、鉴别及诊断，具有 较大临床价值。

Objective To explore the CT imaging manifestations and the application value of CT examination in the clinical differentiation and diagnosis of patients with atypical thoracic sarcoidosis. Methods 73 patients with thoracic and lung lesions treated in our hospital from May 2012 to May 2015 were taken as the research objects. The results pathological examination were taken as the final results. All patients underwent multislice spiral CT scanning. The CT imaging manifestations of patients with atypical thoracic sarcoidosis were summarized and the confirmed results were compared with the results of pathological examination to clearly identify the differential and diagnostic value of CT. Results The main CT imaging manifestation of patients with atypical thoracic sarcoidosis was intrathoracic lymphadenectasis, usually with pulmonary infiltration manifestations, such as ground glass shadow, nodular shadow and irregular linear opacities, complicated with spot-like calcification, clear enlarged lymph nodes boundaries, apparently homogeneous enhancement. A total of 58 cases of atypical thoracic sarcoidosis, 2 cases of tuberculosis, 2 cases of lymphoma and 1 case of metastatic tumor were diagnosed, and the remaining 10 cases were misdiagnosed or missed diagnosed. The accuracy rate in the diagnosis of atypical thoracic nodules was 86.6% (58/67). The main enhancement mode of patients with atypical thoracic sarcoidosis was homogeneous, reaching 65.7%. CT enhancement of metastatic tumor also was homogeneous enhancement, which needed to be identified. The most CT enhancement degree of patients with atypical thoracic sarcoidosis was obvious enhancement, reaching 64.2%, whiloe there was no obvious enhancement in tuberculosis, lymphoma and metastatic tumor, et al, which were easy to identify. Conclusion The application of CT in patients with atypical thoracic sarcoidosis can make the lesions observed more clearly, which is conducive to the localization, differentiation and diagnosis of sarcoidosis, with great clinical value.