肺部恶性局灶性磨玻璃密度结节的MSCT动态征象分析  

Dynamic MSCT Features and Analysis of Pulmonary Malignant Focal Ground Glass Opacity

作　　者：姚军[1] 夏进东[1] 张黎[2] 

机构地区：[1]上海市松江区中心医院放射科,201600 [2]上海市松江区中心医院病理科,201600

出　　处：《临床放射学杂志》2015年第9期1410-1415,共6页Journal of Clinical Radiology

摘　　要：目的探讨肺部恶性局灶性磨玻璃密度结节(f GGO)在MSCT随访复查中的动态征象变化特点。方法回顾性分析经手术病理证实的32例36个恶性f GGO的CT征象,包括14个单纯型磨玻璃密度结节(p GGO),22个混合型磨玻璃密度结节(m GGO),观察对照其初诊与术前CT在形态大小、内部密度、边缘形态及其周围结构等征象的动态变化。结果术前CT征象比初诊CT有明显增多,包括形态发生改变,基本呈圆形/类圆形,境界变清楚,平均大小增加15%(2.1 mm),8个p GGO出现实性成份,22个m GGO实性成份增加,新增"分叶征"13个,"毛刺征"11个,"空泡征"3个、"支气管充气征"2个,"胸膜凹陷征"3个、"血管集束征"5个,局限性肺气肿2个。结论肺部恶性f GGO的各个CT征象随时间经常发生变化,特别是实性成份的出现/增加,"分叶征"、"毛刺征"、"胸膜凹陷征"的出现,认识这些征象的变化,有助于及时做出正确的判断。Objective To explore the dynamic MSCT features of pulmonary malignant focal ground glass opacity（ f GGO） in the follow up. Methods The CT appearance of 32 cases（ 36 nodules） with pulmonary malignant focal ground glass opacity confirmed by postoperative pathology were studied retrospectively. Out of 36 foci of f GGO,pure GGO（ p GGO） were14 and mixed GGO（ m GGO） were 22. The dynamic features of the lesion shape,size,density,speculation,lobulation,and pleural indentation on the preoperative CT images were analyzed and compared with pathological results. Results The CT appearances significantly increased compared with that of the preoperative CT images,including the lesion shape and contour were well defined and round,the lesion size were increased by 15%（ 2. 1 mm）,the lesion density were more solid in8 cases of p GGO,the lesion density were increased in 22 cases of m GGO,and speculation（ n = 13）,irregular（ n = 11）,internal air density（ n = 3）,air bronchogram（ n = 2）,pleural indentaion（ n = 3）,vascular convergence（ n = 5）,focal pulmonary emphysema（ n = 2）. Conclusion The change of the CT image features of f GGO by the time,especially the solid in component in the lesion,speculation,irregularity,pleural indentaion is very helpful in making the diagnosis.

关 键 词：磨玻璃密度 肺结节 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]