经MSCT探讨肺内单发亚实性结节与血管的关系  

MULTI-SLICE SPIRAL CT STUDY OF THE RELATIONSHIP BETWEEN PULMONARY SUBSOLID NODULES AND BLOOD VESSELS

作　　者：季泽强[1] 管星[1] 于志军[1] 秦洪涛[1] 李淑静[1] 

机构地区：[1]河北医科大学第一医院放射科,河北省石家庄市050031

出　　处：《中国煤炭工业医学杂志》2016年第8期1104-1108,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省医学科学研究重点课题(编号:20160685)

摘　　要：目的探讨MSCT图像中肺亚实性结节与供血血管关系及类型，及其对亚实性结节良恶性诊断的意义。方法对88例GGN进行回顾性分析，观察病灶及周围供血血管形态并进行分类，将亚实性结节与供血血管关系分为四种类型：Ⅰ型血管在GGN旁绕行；Ⅱ型完整的血管穿过GGN；Ⅲ型血管在GGN内扭曲、扩张；Ⅳ型更为复杂的血管表现。将分析结果与手术病理及随诊结果对照。结果40例亚实性结节病理诊断为恶性结节。40例亚实性结节与供血血管的关系四种类型（Ⅰ～Ⅳ）分别为0，8，21，11例，Ⅲ型最多。11例Ⅳ型均为浸润性腺癌，21例Ⅲ型中17例为浸润性腺癌，其余2例为原位腺癌，2例为微浸润腺癌，Ⅲ型＋Ⅳ型为浸润性腺癌的可能性非常大，且四组亚实性结节与供血血管关系类型有统计学意义（X2=17．930，P=0．006）。结论多层螺旋CT扫描能清楚显示GGN与其供血血管的关系，其对GGN良恶性性质的诊断和鉴别诊断有重要价值。Objective To investigate the relationship between pulmonary subsolid nodules and blood vessels in MSCT images,and their significance in the diagnosis of benign and malignant nodules. Methods A retro- spective analysis was performed on 88 cases of GGN. The relationships between subsolid nodules and suppl- ying blood vessels were categorized into four types： Ⅰ , vessels passing by GGNs; Ⅱ ,intact vessels passing through GGNs ; [1] , distorted, dilated or tortuous vessels seen within GGNs ; Ⅳ, more complicated vascula- ture other than described above. Relationship types were correlated to pathologic and/or clinical findings of subsolid nodules. Results Forty malignant nodules were diagnosed. Types Ⅰ , Ⅱ , Ⅲ and Ⅳ vascular rela- tionships were observed in 0,8,21 and 11 subsolid nodules, respectively. Type Ⅲ relationship was the domi- nating relationship. All 11 subsolid nodules were invasive adenocarcinomas, when the relationship between subsolid nodules and vessle were typeiv. There were 17 cases of group of invasive adenocarcinoma,2 case of preinvasive group,2 cases of infiltrating adeocarcinomas when the relationship between subsolid and vessel were type Ⅲ. Correlation analysis showed strong correlation between invasive adenocarcinoma and type Ⅲ and Ⅳ. There was significant statistical significance among 4 groups of relationships between subsolid nod- ule vessle（X2 = 17. 930,P = 0. 006）. Conclusions Multi- slice spiral CT scanning can clearly show the relationship between GGN and its blood supply vessels,which has important value for the diagnosis and differ- ential diagnosis of GGN.

关 键 词：血管 腺癌 亚实性结节 体层摄影术 X线计算机 

分 类 号：R737.9[医药卫生—肿瘤]