肺-纵隔交界区肿瘤的多层螺旋CT征象分析  

Study of Multi-slice CT Characteristics in the Evaluation of Tumor in the Pulmonary-mediastinal Junction Region

作　　者：崔冰[1] 周围[1] 李鹏[1] 胡秋根[1] 王浩[1] 

机构地区：[1]佛山市顺德第一人民医院放射科CT室,广东528300

出　　处：《放射学实践》2008年第1期33-36,共4页Radiologic Practice

摘　　要：目的:探讨肺-纵隔交界区肿瘤的多层螺旋CT特征。方法:搜集经手术、活检病理证实的50例肺-纵隔交界区肿瘤,回顾性分析其多层螺旋CT平扫及增强扫描特征,选择分析对肺-纵隔交界区肿瘤定位定性诊断有价值的影像学征象。有价值的CT定位征象主要有:宏观征象:病灶中心位置;病灶与肺及纵隔交界面的夹角;纵隔内脂肪间隙及大血管形态的改变情况;病灶密度(钙化、脂肪等);胸膜增厚及移位情况;纵隔淋巴结肿大情况;胸腔积液;肺内纹理走行、病灶邻近肺野改变;增强扫描特征。细节征象:病灶与纵隔交界面特征;病灶与肺交界面特征。结果:肺癌22例,胸腺肿瘤20例,生殖细胞肿瘤3例,神经源性肿瘤5例,总的诊断符合率达到95%。结论:多层螺旋CT扫描及增强扫描特征,尤其是肿瘤与肺-纵隔分别的交界面情况,胸膜的移位情况,纵隔内大血管形态、位置改变等等,能对肺-纵隔交界区肿瘤作出正确的定位定性诊断。Objective：To study the multi-slice CT （MSCT） features of tumor in the pulmonary-mediastin junction in order to improve the accuracy of diagnosis. Methods：The MSCT （HRCT and contrast enhanced CT） characteristics of 50 cases with surgery and pathology proved pulmonary-mediastinal junction tumor were analyzed retrospectively. The criteria to be analyzed included： location of the tumor center; the angle between lesion and lung/mediastinum;the change of intra-mediastinal fatty space and the outline of blood vessels; the intra-tumoral density （calcification, fat） ;local pleural thickening;mediastinal lymphadenopathy; pleural effusion;alignment of lung markings;change of lung adjacent to the tumor and the characteristics of enhanced MSCT. The detail characteristics should be noticed included：interfaces between tumor and lung as well as mediastinum. Results： Of the 50 patients, there were lung cancer （ n = 22 ）, thymus neoplasm （ n = 19 ）, germ cell tumor （n= 6）, and neurogenic tumor （n= 5）. Ninety-five percent of diagnostic accuracy was obtained by comprehensive imaging analysis before surgery. Conclusion：MSCT （HRCT and contrast enhanced CT） findings provided important information in the diagnosis of the location and nature of tumors located at the pulmonary-mediastinal junction region.

关 键 词：肺肿瘤 纵隔肿瘤 体层摄影术 X线计算机 

分 类 号：R734[医药卫生—肿瘤]