低剂量CT肺癌筛查检出肺癌的影像特征  

Imaging characteristics of lung cancer detected by low-dose CT lung cancer screening

作　　者：王建卫[1] 吴宁[1] 唐威[1] 黄遥[1] 赵世俊[1] 李蒙[1] 周丽娜[1] 王玉婕[1] 陆雯雯[1] 刘士远[2] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院影像诊断科,100021 [2]第二军医大学附属长征医院影像医学与核医学科

出　　处：《中华放射学杂志》2015年第5期336-339,共4页Chinese Journal of Radiology

基　　金：北京市科委重点项目（D1411000002140061;固家自然科学基金面上项目（81171344）;上海市科委重大专项（13411950100）;2014卫生计生委公益性行业科研专项（201402013）;美国国际早期肺癌行动计划国际合作课题（09-09/304）

摘　　要：目的分析低剂量CT（LDCT）筛查检出肺癌的影像特征。方法回顾性分析2007年7月1日至2013年6月30日接受LDCT筛查受检者7141例，其中男4710例、女2431例，年龄40~88岁，中位年龄47岁，行9721次LDCT检查。≤39岁自愿参加筛查者1071例。对手术和病理证实的肺癌进行影像学分析，根据肺内病变是否含有磨玻璃密度影（GGO）、是否能够完全遮盖肺实质，将病变分为实性、部分实性和非实性3类。结果 LDCT检出肺癌患者31例，检出率为0.4%；32个癌灶中腺癌30个、类癌和小细胞肺癌各1个。31个非小细胞肺癌病灶中，实性结节共18个，其中实性结节经典型14个、不规则型2个、不典型结节型2个；部分实性结节12个，其中部分实性结节型8个、不规则型2个、囊腔型2个；非实性型1个。LDCT诊断肺癌或肺癌可能性大24个（77.4%）、不能定性或定性困难3个（9.7%）、诊断良性或良性可能大3个（9.7%）、基线筛查漏诊1个（3.1%）。结论 LDCT筛查检出的肺癌影像表现多样，可为LDCT肺癌筛查提供借鉴。Objective To analyze the imaging characteristics of lung cancer detected by LDCT （ low-dose CT ）lung cancer screening. Methods Between July 1st, 2007 and June 30th, 2013, 7 141 asymptomatic enrolled participants aged 40-88 years old （male 4 710, female 2 431, median age 47）, and 1 071 volunteer participants aged ≤39 underwent chest LDCT. The imaging characteristics were analyzed retrospectively in lung cancer pathologically proved. Three types were classified according to the imaging findings： solid lesion, part-solid lesion and non-solid lesion. Results A total of 31 participants （32 lesions） were diagnosed as lung cancer, including 30 adenocarcinomas, 1 carcinoid and 1 small cell lung cancer. The detecting rate of the lung cancer was 0.4%（31/8 212）. The solid lesion was further classified as classical solid nodule, irregular solid lesion and atypical solid nodule, and the part-solid lesion was further classified as part-solid nodule, irregular part-solid lesion and cystic part-solid nodule. Lung cancer or probably lung cancer was diagnosed in 24 cases （77.4%）, and uncertainty diagnosis was made in 3 cases （9.7%）. Benign or probably benign was diagnosed in 3 cases, and another 1 cases were missed at baseline screening. The false positive rate and the false negative rate was 9.7%and 3.1%, respectively. Conclusion The imaging characteristics of lung cancer detected by LDCT are varied, which provide preliminary experience in lung cancer screening.

关 键 词：肺肿瘤 体层摄影术 X线计算机 辐射剂量 

分 类 号：R734.2[医药卫生—肿瘤]