多层CT显示肺结节细分叶征及其对孤立性肺结节的诊断价值  

Fine lobulation sign in multi-detector computed tomography imaging and its diagnostic value in solitary pulmonary nodule

作　　者：李惠民[1] 于红[2] 

机构地区：[1]上海交通大学医学院附属新华医院放射科,上海200092 [2]第二军医大学第二附属医院影像科,上海200003

出　　处：《诊断学理论与实践》2010年第2期152-154,共3页Journal of Diagnostics Concepts & Practice

摘　　要：目的:使用多层CT(MDCT)显示肺结节的细分叶征并探讨其在孤立性肺结节(SPN)诊断中的价值。方法:本组共收集CT横断面SPN最大直径≤30mm的病例62例,其中周围型肺癌32例,良性SPN30例,采用四层CT扫描仪对每个病例均完成容积显示(VR)处理并使用自主调节的模式进行显示。结果:肺癌的分叶征出现率为93.8%(30/32),明显高于非肺癌结节(良性SPN)[46.7%(14/30)],(χ2=16.660,P=0.001)。7例(21.9%)肺癌结节出现典型的细分叶征,其中肺泡癌4例,腺癌3例。无一例良性SPN出现细分叶征。典型的细分叶征表现为VR上肺结节表面有5个以上的微小半球形突起(直径不超过5mm),常规CT横断面不能显示该特征。结论:MDCT的VR图像可以很好地显示肺癌结节的细分叶征,该征可能是周围型肺癌的定性诊断特征。Objective To appraise the fine lobulation sign in MDCT （multi-detector CT） imaging and its diagnostic value in solitary pulmonary nodule （SPN）. Methods Sixty-two cases of solitary pulmonary nodule with CT axial imaging diameter ≤ 30 mm,including 32 cases of peripheral pulmonary cancer and 30 cases of benign SPN were studied. Fourrow MDCT with 1.0 mm collimation,1.3 mm slice thickness,0.6 mm interval and 180-220 mm FOV （field of view） was used. VR （volume rendering） images with autogenous modulation were obtained in all of the cases. Results Lobulation sign was seen in 93.8% （30/32） of the pulmonary cancer cases,significantly higher than that in benign SPN （46.7%,14/ 30,χ^2 = 18.660,P = 0.001）. Seven （21.9%） of the pulmonary cancer cases showed typical fine lobulation sign,including 4 alveeolar cancer and 3 adenocarcinoma. None of the benign SPN case had fine lobulation sign. Typical fine lobulation sign was shown in VR images as more than 5 spherical spurs with a diameter ≤ 5 mm on the surface of SPN,which could not been seen on routine CT images. Conclusions VR image of MDCT could clearly display typical fine lobulation sign,which might be a characteristic sign for diagnosing peripheral pulmonary cancer.

关 键 词：周围型肺癌 孤立肺结节 容积显示 分叶征 诊断 

分 类 号：R734.2[医药卫生—肿瘤]