CT支气管征对周围型肺孤立性病灶的诊断价值  

The diagnostic value of CT bronchial sign in peripheral solitary pulmonary lesions

作　　者：孙鹏飞[1] 肖湘生[1] 刘士远[1] 于红[1] 李惠民[1] 

机构地区：[1]第二军医大学附属长征医院影像科,上海

出　　处：《中华放射学杂志》2008年第9期927-931,共5页Chinese Journal of Radiology

基　　金：上海市科委重点课题（06DZ19503）,长征医院“三重三优”学科人才建设计划-重大临床项目

摘　　要：目的探讨CT支气管征对周围型肺孤立性病灶的鉴别诊断价值。方法对111例周围型肺孤立性病灶患者进行螺旋CT扫描并进行后处理重组，分析病灶与支气管关系类型，并进行χ^2检验，比较其在良、恶性病灶间的差异。结果周围型肺孤立性病灶支气管边缘截断率在恶性病变（47／95，49．5％）明显高于良性（10／42，23．8％）（χ^2=7．896，P〈0．05），Ⅰ、Ⅱ型支气管充气征在恶性病变（分别为10／11、8／9）出现率高于良性（分别为1／11、1／9；χ^2值分别为6．975、4．818，P〈0．05），而Ⅳ型在良性病变（12／17）的出现率明显高于恶性（5／17；χ^2=7．390，P〈0．05）；支气管在病灶边缘走行、支气管牵拉移位在良性（9／24、1／4）、恶性病灶（15／24、3／4）间差异无统计学意义（χ^2值分别为0．641，0．062，P〉0．05）；管壁局限性增厚在恶性病变（21／22）出现率高于良性（1／22；χ^2=4．185，P〈0．05），而广泛性增厚在良性病变（4／7）出现率明显高于恶性（3／7；χ^2=8．650，P〈0．05）。结论CT支气管征对周围型肺孤立性病灶良、恶性的鉴别有重要价值。Objective To investigate the differential diagnostic values of CT bronchial sign for peripheral solitary pulmonary lesions （ SPLs ）. Methods One hundred and eleven patients with peripheral SPLs were scanned using muhi-slice helical CT （MSCT） , and muhiplanar reconstruction was performed to show the relationship between the lesion and bronchus, the differences between the benign and malignancy were compared by using chi-square test. Results Bronchial cutoff rate in malignant lesions （47/95, 49. 5% ） was markedly higher than that in benign lesions （ 10/42,23.8%. χ^2 = 7. 896, P 〈 0. 05 ）, the frequency of type Ⅰ and type Ⅱair bronehogram presented in malignant lesions （10/11.8/9） was higher than benign lesions（ 1/11,1/9.χ^2 = 6. 975,4. 818, P 〈 0. 05 ） , but type Ⅳ in benign lesions （12/17） was more common than that in malignant lesions （5/17.χ^2 =7. 390,P 〈0.05）. No significant difference was found in bronchus ran at the periphery of the lesion and bronchus dragged by the lesion between benign （9/24,1/4） and malignant lesions （ 15/24,3/4. χ^2 = 0. 641,0. 062, P 〉 0.05 ）. The focal bronchial wall thickening in malignancy （21/22） was markedly higher than benign lesions （1/22.χ^2 = 4. 185 ,P 〈 0. 05）, whereas the extensive thickening in benign lesions （4/7） was more common （ 3/7. χ^2 = 8. 650, P 〈 0.05 ）. Conclusion CT bronchial sign is very important in the differentiation of benign and malignant pulmonary lesions.

关 键 词：硬币病变 肺 支气管疾病 体层摄影术 X线计算机 

分 类 号：R686[医药卫生—骨科学]