细支气管肺泡癌影像学特征的深入性探讨  

Intensive Study on the Image Characteristics of Bronchioloalveolar Carinoma

作　　者：邓宇[1] 曾庆思[1] 伍筱梅[1] 蔡超达[1] 谢念危[1] 陈国勤[2] 

机构地区：[1]广州医学院第一附属医院放射科,广州510120 [2]广州医学院第一附属医院病理科,广州510120

出　　处：《放射学实践》2005年第2期128-131,共4页Radiologic Practice

摘　　要：目的:研究细支气管肺泡癌的影像学特征及相应病理学基础,提高对该病的认识及诊断水平。方法:回顾性 对比分析49例经纤维支气管镜、穿刺活检或手术病理证实的细支气管肺泡癌的胸部高千伏摄影及CT表现,探讨各型病 变的影像特征。结果:根据大体病理及相应影像上病变的形态和分布特点,可将细支气管肺泡癌分为孤立结节型(25例)、 多发结节型(5例)及弥漫实变型(19例)。孤立结节型相对特异性的征象有多分叶征72%、空气支气管征68%、晕征 40%、血管包埋征20%等,21例(84%)病变在HRCT上具有5个以上的上述征象;多发结节型表现为两肺弥漫结节3例, 网织结节2例,相邻结节可融合成块,伴小叶间隔增厚2例;弥漫实变型表现为单纯大叶性实变2例,伴有非实变区多发 结节及磨玻璃样影17例,主要征象有细支气管夹角增宽13例,血管造影征14例,碎石路征9例。结论:细支气管肺泡癌 的影像表现复杂多样,对各型的征象特别是HRCT表现进行深入细致地分析,可提高本病的诊断符合率。Objective:To investigate intensively the imaging charcrateristics of BAC and correlate them with pathologic basis,and to improve the accuracy of diagnosis of the disease.Methods:The chest film and CT findings of 49 cases of patho- logically proven bronchioloalveolar carinoma by bronchoscopy or surgery were analysed,and the imaging characteristics were discussed.Results:According to imaging and pathological finding;BAC could be classified into three types of patterns:solitary nodule (n=25),multiple nodules (n=5) and diffuse consolidation (n=19).Diagnostic features of solitary nodule type were halo sign (40%),multi-lobulation sign (72%),air-bronchogram sign (68%) and vascular embedded sign (20%).21 of 25 SBAC (84%) had 5 or more malignant signs on HRCT;Multiple nodules type showed diffuse distributed nodules in 3 cases,and reticulonodular shadow in 2 cases,adjacent nodules merged to mass,with thickend interlobular septa in 2 cases.2 cases of diffuse consolidation type showed consolidation of more than half of a lobe or lobes,whereas associated multiple nodules and patchy shadow of non-consodiation area were found in 17 cases,widening of the branch angle of bronchiole in 13 cases,angiogram sign in 14 cases and “crazy paving” pattern in 9 cases.Conlusion:The imaging features of BAC were complicated,more exact dignosis could be made after intensilvely investigating imaging features especially findings on HRCT.

关 键 词：肺肿瘤 体层摄影术 X线计算机 X线摄影术 

分 类 号：R734.2[医药卫生—肿瘤]