肺孤立结节与周围肺血管增强CT表现及其与病理的关系  

Enhanced CT Features of Solitary Pulmonary Nodule and Adjacent Pulmonary Vessels and Their Correlation with Pathology

作　　者：朱培菊[1] 郭大静[2] 肖家和[1] 杨敏[1] 邓开鸿[1] 

机构地区：[1]华西医科大学附属第一医院放射科,成都610041 [2]重庆医科大学附属第二医院放射科

出　　处：《临床放射学杂志》2000年第9期556-558,共3页Journal of Clinical Radiology

摘　　要：目的　探讨肺孤立结节增强CT表现特点、周围肺血管异常改变与病理的关系。材料与方法　 46例不同病理性质的孤立肺结节 (直径 10～ 3 0mm)行螺旋CT增强扫描 ,研究结节强化特点及其周围肺血管改变。全部病例均经手术及病理证实。结果　 46例肺孤立性结节强化者 42例 ,全部肺癌和炎性结节均显著强化 ,其中结节呈均匀和不均匀强化各 16例 (肺癌 19例 ,炎性假瘤 8例 ,错构瘤 1例 ,结核瘤 4例 ) ;周围强化 10例 ,其中肺癌 5例 ( 3例呈环状强化 ) ,炎性结节 5例 ( 3例肺脓肿呈环状 )。未强化者 4例 (肺结核 3例 ,错构瘤 1例 )。表现结节内血管征 9例 ,其中肺癌 7例 ,炎性假瘤 2例。局部充血征 6例 ,均为炎性结节 ;淤血征 8例 ,肺血管纠集征 7例 ,均为肺癌。结论　肺癌、炎性结节较结核瘤显著强化 ,结节强化表现与病理无明显相关性 (P >0 .0 5 ) ;结节内血管征、邻近肺野局部充血、淤血及血管纠集征则对鉴别诊断炎性结节与肺癌具有重要意义。Objective To study CT features of solitary pulmonary nodules (SPNs) and adjacent pulmonary vessels, and their pathologic basis.Materials and Methods Enhanced spiral CT scanning was performed in 46 cases with proved SPNs of different pathology (10～30mm in dia meter), and CT findings were analyzed.Results Of 46 SPNs, 42 were enhanced. All cancerous and inflammatory nodules were enhanced significantly. Homogenous and heterogeneous enhancement were 16 for each, including lung cancer (n=19), inflammatory pseudotumor (n=8), hamartoma (n=1) and tuberculoma (n=4). Peripheral enhancement was seen in 10 nodules, including lung cancer (n=5) and inflammatory (n=5). Three tuberculomas and 1 hamartoma did not show enhancement. Angiogram sign within nodule was seen in 9 SPNs, of which 7 were lung cancers, 2 inflammatory pseudotumors. Localized hyperemia sign was seen in 6 inflammatory nodules, while congestion sign in 8 and convergence sign of pulmonary vessels in 7 cases of lung cancer.Conclusion Cancerous and inflammatory nodules show more significant enhancement than tuberculoma, while no correlation exists between their enhancement and pathology results (P>0.05). Angiogram sign within nodule, localized hyperemia or congestion sign and convergence sign of pulmonary vessels have great value in differentiating inflammatory nodules from lung cancers.

关 键 词：肺孤立结节 肺癌 周围肺血管 CT 病理 诊断 

分 类 号：R816.41[医药卫生—放射医学] R734.204[医药卫生—临床医学]