肺腺癌浸润前病变的CT诊断  

CT diagnosis of pre-invasive pulmonary adenocarcinoma lesions with ground-glass opacity

作　　者：何亚奇[1] 唐秉航[1] 林乐[1] 全勇[1] 黄德成[1] 

机构地区：[1]中山市人民医院CT室,广东528403

出　　处：《放射学实践》2017年第8期835-838,共4页Radiologic Practice

基　　金：广东中山市社会公益科技研究项目(2016B1033)

摘　　要：目的:探讨肺腺癌浸润前病变的CT表现。方法:回顾性分析2011年3月-2016年12月经手术病理证实的45例肺腺癌浸润前病变患者的临床和CT资料,其中不典型腺瘤样增生(AAH)10例、原位癌(AIS)35例,主要分析指标包括病灶分布、大小、密度、分叶征、毛刺征、空泡征、充气支气管征、肿瘤微血管成像征和胸膜凹陷征。结果:35例表现为纯磨玻璃密度结节、10例为部分实性成分磨玻璃密度结节;AAH组和AIS组中病灶直径分别为(10.15±3.72)和(11.73±4.58)mm,平均CT值分别为(-514±70.66)和(-477.2±168.08)HU,两组间差异均无统计学意义(P>0.05)。CT征象中以肿瘤微血管成像征最多见(出现率为68.9%),其次是分叶征、空泡征(均为26.7%),充气支气管征最少见(4.4%);两组间各征象的差异均无统计学意义(P>0.05)。结论:肺腺癌浸润前病变的CT征象中肿瘤微血管成像征具有一定特异性,CT形态学征象并不能准确鉴别不典型腺瘤样增生和原位癌。Objective： To study the CT appearances of pre-invasive pulmonary adenoeareinomas （PIPAC）. Methods： The clinical and CT data of 45 patients with PIPAC confirmed by surgery and pathology from March 2011 to December 2016 were analyzed retrospectively. There were 10 patients with atypical adenomatous hyperplasia （AAH） and 35 patients with adenoeareinoma in situ （AIS）. The HRCT findings for each nodule were analyzed according to the following parameters ： location, size, density, lobulated shape, spiculated margin, vacuole sign, air bronchogram sign, mieroangiogram sign a.nd pleural indentation. Results： In the 45 eases,there were 35 pure ground-glass nodules （GGNs） and 10 part-solid GGNs. The average size of AAHs and AISs was （10.15 ± 3.72） and （ 11.73 ± 4.58） mm respectively, and the average CT value was （-514.00±70.66） and （-477.20± 168.08）HU; there was no statistical difference between the two groups of lesions （P〉0.05）. The most common CT manifestation was mieroangiogram sign with occurrence ratio of 68.9%, the next were lobulated border and vacuole sign （26.7 % for each）, and most infrequent manifestation was air bronchogram sign （4.4%, There was no significant difference in morphologic findings on CT between AAHs and AISs group （P〉0.05）. Conclusion： Mieroangiogram sign is a characteristic manifestation of pre-invasive pulmonary adenocareinomas, but the morphologic manifestations on CT can not distinguish AAH from AIS accurately.

关 键 词：体层摄影术 X线计算机 肺腺癌 诊断 

分 类 号：R730.44[医药卫生—肿瘤] R734.2[医药卫生—临床医学]