38例周围型肺癌X线征象分析  

Around Type Lung Cancer X-ray Sign Analysis(38 Cases Report)

作　　者：陆鹏社[1] 王庆国 李健[3] 张艳[3] 

机构地区：[1]西北农林科技大学医院,712100 [2]咸阳市妇幼保健院 [3]陕西省人民医院CT室

出　　处：《现代医用影像学》2008年第5期255-256,共2页Modern Medical Imageology

摘　　要：目的:通过对38例周围型肺癌早期X线征象的分析,探讨早期X线诊断标准。材料与方法:对38例早期周围型肺癌(腺癌24例,鳞癌8例,小细胞癌6例;伴纵隔淋巴结转移12例、脑转移6例)的X线分析,以利提高诊断水平。结果:38例早期周围型肺癌的病灶直径1.1cm～4.8cm,平均为1.65cm,据其形态分为3个类型:(1)小结节型25例(26个病灶),病灶密度中等偏低,有细小毛刺征15例,浅分叶征11例、胸膜凹陷征7例、小泡征5例及钙化斑点1例;(2)小斑型7例,病灶边缘模糊似星芒状,形态不规则;(3)小空洞型6例,呈中心性厚壁空洞4例,呈灶性小空洞2例。所有病灶外围均无卫星病灶。结论:肺内≤2cm的孤立结节、斑片状或空洞阴影,形态不规则,灶内有小泡征,边缘有浅分叶征、细小毛刺征等均考虑肺癌且以腺癌可能性大;注意与肺内常见结节鉴别;定性确有困难者可选择CT扫描,采用X线动态观察,但时间不宜超过3个月;必要时选择痰检、肺穿刺活检、或手术治疗。Purpose： Through to 38 examples around lung cancer early X sign analysis, Discussion early time X diagnosis standard. Materials and Methods： To 38 example early times periphery lung cancer （adenocarcinoma 24 examples, scale cancer 8 examples, cellule can- cer 6 examples： Accompanies the mediastinum lymph node to shift 12 examples, the brain shift 6 examples） x sign analysis, in order to help enhancement diagnosis level. Results： Periphery 38 example early times lung cancer diameter 1. 1cm ～ 4.8cm, is 1.65cm equally, divides into 3 types according to its shape： （1） tubercle 25 examples （26 infections）, infection density medium somewhat low, has the tiny burr to draft 15 examples, the shallow sublobe to draft 11 examples, the pleural to draft 7 examples, slightly to soak hollowyly drafts 5 examples and the calcification spotlexample; （2） small spot piece 7 examples, the infection edge blurry resemble the form of starloike rays, the shape are anomalous; （3） small cavity 6 examples, assume the centricity thick wall 4 examples, assumes the stove （2） the small 2 examples, All infection periphery does not have the satellite infection. Conclusion： In lung ≤2cm the isolated tubercle, the spot laminated shape or the empty shadow, the shape is anomalous, in the stove has slightly soaks drafts, the edge has the shallow sublobe to draft, the tiny burr to draft and so on to consider the lung cancer, and is big by the adenecarcinoma possibility; In attention and lung common tubercle distinction; Qualitative really has the di^culty to be possible to choose the CT scanning; May also use X dynamic observation, but the time is not suitable surpasses for 3 months; When necessity chooses the phlegm to examine, the lung puncture biopsy, or the surgery treats.

关 键 词：肺癌 X线 断层摄影术 诊断 

分 类 号：R734.2[医药卫生—肿瘤] R571.1[医药卫生—临床医学]