11例具有局限性磨玻璃样密度影表现的肺癌X线分析  

Radiologic analysis of 11 lung cancer with localized ground-glass opacity

作　　者：蒋磊 陈福康 吴建彬 黄海峡 潘祖军 黄吟华 吴科峰 

机构地区：[1]华东疗养院放射科,江苏无锡214065

出　　处：《中国医学影像技术》2004年第z2期43-45,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　通过对表现为局限性磨玻璃密度影肺癌的X线表现的认识 ,提高其初诊正确率 ,减少漏误诊。方法　收集我院通过健康体检发现并经病理证实的 11例具有局限性磨玻璃样密度影的肺癌病例 ,回顾分析病人的数字化体层片 ,对肺癌瘤体的大小、形态、密度、边缘特征等进行分析。结果　病理类型 :细支气管肺泡癌 (6/11) ,肺腺癌 (5 /11)。体层片上瘤体密度形态表现 :①完全磨玻璃样密度结节 (4 /11) :病变密度低而均匀 ,其内可见血管影穿过。边缘较模糊 ,但尚可指示范围。 1例见浅分叶及切迹 ,其余均未见分叶征毛刺征等。②混有磨玻璃密度影的结节 (7/11) :病变密度不均匀 ,在磨玻璃密度结节中混有局灶性的高密度实性成分 ,显示结节征 (7/7) ,小泡征 (5 /7) ,毛刺征 (5 /7) ,分叶征 (5 /7) ,胸膜凹陷征 (3 /7) ,支气管气相 (2 /7)。肺癌瘤体在正侧位胸片中的显示率低 ,为 18% (2 /11)。结论　磨玻璃样密度结节可以是早期细支气管肺泡癌及肺腺癌的一个X线征象 。Objective To understand further the x-ray signs of peripheral lung cancer with localized ground-glass opacity,and to improve its diagnostic accuracy. Methods We collected 11 cases of peripheral lung cancer with localized ground-glass opacity,confirmed by surgery and pathology by health checkup in recent years.All cases were detected by videofluoroscopy,then took chest plain film,the spot film and tomogram.We reviewed the tomogram and analysed the size,appearance,density,margin,et al of solitary lesions. Results The histological type of lung cancer:brochioloalveolar carcinoma in 6(55%), adenocarcinoma in 5(45%).The appearance on the tomogram: ①pure ground-glass opacity(4/11):The lesion density were low and even,the vessels inside of nodule cound be seen,the nodule margin blurred but limited.The shallow lobulation in one case,the others were no lobulation and spiculation.②nodule mixed ground-glass opacity(7/11):The lesion density were uneven,localized consolidation cound be seen in ground-glass opacity,the main X-ray signs included node sign(7/7), vacuoie sign(5/7), spiculation(5/7),lobulation(5/7),pleural indentation(3/7),air-bronchogram(2/7).There were only two patients(18%) detected by plain film in 11 cases of peripheral lung cancer detected by videofluoroscopy. Conclusion The localized ground-glass opacity is the early sign of early brochioloalveolar carcinoma and adenocarcinoma.The thoracic videofluoroscopy and digital radiography(the spot film and tomogram)are a important means of effectively detecting localized ground-glass opacity and screening peripheral lung cancer.

关 键 词：肺癌 磨玻璃密度影 电视透视 数字化 体层摄影术 

分 类 号：R814.41[医药卫生—影像医学与核医学]