微浸润型肺腺癌的高分辨率CT表现  

High-resolution CT Manifestation of Minimally Invasive Pulmonary Adenocarcinoma

作　　者：孟庆成[1] 贾丙鑫[1] 张建伟[1] 陈学军[1] 张风光[1] 杨宏伟[2] 

机构地区：[1]河南省肿瘤医院放射科,河南郑州450003 [2]河南省肿瘤医院病理科,河南郑州450003

出　　处：《中国医学影像学杂志》2013年第7期536-538,542,共4页Chinese Journal of Medical Imaging

摘　　要：目的探讨微浸润型肺腺癌的高分辨率CT(HRCT)表现及病理特征。资料与方法经病理证实的微浸润型肺腺癌患者24例,术前均行低剂量螺旋CT扫描,病灶行常规HRCT扫描,观察病灶的HRCT表现及病理特征。结果 24例患者均为单发磨玻璃样结节影,位于周围肺野。其中纯磨玻璃样结节8例,混合磨玻璃样结节16例,病灶直径(2.3±0.4)cm。其他影像学征象包括细支气管扩张征18例、边缘清晰18例、胸膜凹陷13例、分叶12例及毛刺征12例;量化分型中Ⅰ～Ⅲ型19例,Ⅳ～Ⅴ型5例病理显示肿瘤细胞沿肺泡壁附壁性生长,肺泡间隔增厚。结论 HRCT检查发现磨玻璃样结节影时,如果伴有细支气管扩张征、边缘清晰、胸膜凹陷、毛刺征及量化分型较低时,应高度怀疑微浸润型肺腺癌的可能。Purpose To investigate the high-resolution CT （HRCT） manifestation and pathological characteristics of minimally invasive adenocarcinom. Materials and MethodsTwenty-tbur invasive adenocarcinom patients confirmed by pathology received low dosage spiral CT scan before surgery, then the lesions were underwent routine HRCT scan and the manifestation of HRCT and pathological characteristics were evaluated. Results Single ground-glass nodule in the peripheral pulmonary field was demonstrated for 24 patients, including pure ground-glass nodule 8 cases and mixed ground-glass nodule 16 cases withthe diameter of the lesion （2.3±0.4） cm. The other imaging characteristics included 18 cases bronchiolectasis sign, 18 cases clear margin, 13 cases pleural indentation, 12 cases lobulate and 12 cases spur sign. The typesⅠ - Ⅲ of the quantification grouping harbored19 cases, the Ⅳ-Ⅴ types had 5 cases. The pathology showed that the tumor cells presented mural growth manner along with the alveolar wall and the alveolar septum thickening Conclusion The ground-glass nodules with the bronchiolectasis sign, clear margin pleural indentation, lobulate sign, spur sign and low quantification types on HRCT images should be highly suspected as minimal invasive adenocarcinoma.

关 键 词：肺肿瘤 腺癌 体层摄影术 螺旋计算机 

分 类 号：R734.2[医药卫生—肿瘤] R445.3[医药卫生—临床医学]