摘要
目的探讨传统胸片及胸部CT平扫和增强在诊断原发周围型小肺癌的临床价值。资料与方法回顾性分析八年来经手术和穿刺活检等病理证实,有完整资料的21例单发周围型小肺癌。所有病人通过传统X线、常规CT平扫及增强扫描并分析影像特征。结果 21例中腺癌9例,鳞癌8例,小细胞癌3例,腺鳞癌1例。21例在CT片上均显示为肺炎间质型、单发小结节型、肿块型、混合型等特点的恶性肺浸润方式。分叶征(7/21),毛刺征(14/21),空泡征(8/21),血管纠集征(5/21),胸膜凹陷征(4/21),沙粒状钙化(2/21)。病变均位于肺外围。21例做了增强扫描,病灶呈中度增强,CT值增幅为20Hu-40Hu。结论采用传统X线胸片、CT增强,结合CT导向下穿刺活检,对提高诊断单发小结节性肺癌的认识和定性诊断十分重要,明显缩短临床观察时间,有利于提高患者的存活率和生存质量。
Objective To explore the clinical value of diagnosis primary peripheral pulmonary carcinoma referring to conventional chest film as well as thoracic CT scan,plain and enhanced. MateriaIs and methods Retrospective analysis on 21cases of solitary peripheral pulmonary carcinoma during 8 years,which are pathologically confirmed by operations and biopsies and with complete data.All patients in the cases,screened by conventional X-ray,have conducted conventional plain CT scan,TLC scanning of the focus zone and enhanced sanning. Imaging analysis on them has carefully made. Results Amongst these 21 cases,there are 9 adenocarcinomas,8 squamous cell carcinomas,3 small cell carcinomas and 1 adenosquamous carcinoma.All of them are malignancy invasion pattern of the lung characterized by pneumonia interstitial type,solitary small nodular type,tumid type,etc. We have found sign of lobulation （7/21）,spicule sign（14/21）, air bronchograms（8/21）, convergence of peripheral vessels（5/21）,pleural indentation（4/21）and slipped scattered calcification（2/21）.All the pathological changes appear on the periphery of lung.Enhanced scanning in these 21 cases show that the focuses are moderate enhancement and the amplitude of Ctvalue are 20Hu-40Hu. Conclusion It is of great importance to better understand and qualitative diagnose solitary small nodularperipheral pulmonary carcinoma by using conventional X-ray chest film,thoracic CT scan,plain and enhanced,and needle biopsy conducted by CT.The period of clinical observation can be notably shortened and the diagnosis can be timely made.It is also helpful to select therapeutic methods and give prognosis,improving the patients＇ livability and their quality of life.
出处
《罕少疾病杂志》
2011年第6期13-16,共4页
Journal of Rare and Uncommon Diseases
关键词
周围型小肺癌
影像早期诊断
peripheral pumonary carcinoma, imaging diagnosis
