肺内淋巴结的CT表现特点及与病理对照  

CT features of intrapulmonary lymph nodes： a comparative study with pathology

作　　者：吴光耀[1] 唐丽萍[1] 朱瑞萍[2] 伍建林[1] Wu Guangyao;Tang Liping;Zhu Ruiping;Wu Jianlin(Department of Radiology,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China)

机构地区：[1]大连大学附属中山医院放射科,116001 [2]大连大学附属中山医院病理科,116001

出　　处：《中华放射学杂志》2018年第7期513-517,共5页Chinese Journal of Radiology

摘　　要：目的探讨肺内淋巴结（IPLNs）的CT表现特点及其病理学基础，以提高对IPLNs的认识和诊断水平。 方法回顾性分析2010年3月至2016年12月经手术与病理证实的38例共计49枚IPLNs，其中男21例、女17例，平均年龄（56±8）岁。所有患者术前均经MSCT扫描并行1.0 mm薄层重建，采取双盲法行CT征象分析，并对照相应的组织病理学改变。 结果（1）部位：均位于气管隆突水平以下，左肺17枚，右肺32枚。（2）形态：34枚呈类圆形，15枚呈三角形或棱形等。（3）大小：最大径范围0.26~1.28 cm，平均（0.66±0.23）cm，其中不大于1.0 cm者45枚。（4）数量：28例为单发，10例为多发。（5）密度：48枚均为实性结节，CT值中位数及范围为43 HU（19~106 HU），未见钙化、空泡及空气支气管征。（6）边缘及胸膜：48枚边界均清晰光滑；45枚距胸膜≤1.0 cm，其中20枚紧贴胸膜或叶间裂（5枚）。（7）其他：均未见＂卫星灶＂、胸膜凹陷征、血管集束征；22枚周边见细线影。（8）病理：暗褐色或灰黑色结节，边界清楚有包膜，质韧偏硬，大部分见不同程度炭末沉积。 结论IPLNs为肺内良性结节，具有一定CT表现特点和典型病理改变，依据其CT表现特点有助于术前作出正确的诊断。ObjectiveTo explore the CT features and pathology of intrapulmonary lymph nodes （IPLNs）, so as to improve the understanding and diagnosis of IPLNs. MethodsA total of 38 patients （49 IPLNs） who were confirmed by the surgery and pathology were retrospectively analyzed, including 21 males and 17 females with a mean age of （56±8） years. All the patients underwent MSCT scan and 1.0 mm thin layer reconstruction before surgery. Double-blind method was used to analyze CT signs and the corresponding histopathological changes were compared. Results（1） Location： all IPLNs were located below the level of tracheal carina with 17 were on the left lung, and 32 were on the right lung. （2） Shape： 34 IPLNs were round, 15 were triangular or prism and so on. （3） Size： the maximum diameter of IPLNs ranged from 0.26 to 1.28 cm （0.66±0.23 cm）, of which 45 cases were ≤ 1.0 cm. （4） Quantity： 28 IPLNs were solitary and 10 were multiple. （5） Density： All 48 IPLNs were solid nodules with a median CT value of 43 HU （range from 19 to 106 HU）, and there were no calcification, vacuoles and air bronchial signs were showed. （6） Margin and pleura： all the 48 IPLNs boundaries were clear and smooth, and 45 pieces were less than 1.0 cm from the pleura, of which 20 were close to the pleura or inter-lobar fissure. （7） Other： no ＂satellite focal＂ , pleural depression syndrome, and vascular bundle sign were showed;22 peripheral fine lines of IPLNs were visible. （8） Pathology： IPLNs were dark brown or gray-black nodules with well-defined borders, coated, tough, hard, and carbon deposition could be seen in most cases. ConclusionIPLNs are benign nodules in the lung, which have certain CT features and typical pathological changes. Based on the CT performance and characteristics, it is helpful to make correct diagnosis of IPLNs before operation.

关 键 词：肺内淋巴结 体层摄影术 X线计算机 病理学 

分 类 号：R563[医药卫生—呼吸系统] R816.41[医药卫生—内科学]