直结肠癌肺转移CT诊断及易发因素分析  

CT diagnosis and predisposing factors of lung metastasis from colorectal cancer

作　　者：李标达 王丽华[2] 黄炯强[3] 蒙秋华[1] LI Biaoda;Wang Lihua;Huang Jionggqiang;Meng Qiuhua(Department of Radiology,the First Affiliated Hospital of Guangzhou Medical University,Guangdong 510120,China)

机构地区：[1]广州医科大学附属第一医院放射科,510120 [2]中山大学附属第一医院胸外科 [3]广州医科大学附属第一医院胃肠外科,510120

出　　处：《实用医学影像杂志》2018年第5期407-409,共3页Journal of Practical Medical Imaging

摘　　要：目的回顾直肠、结肠癌肺部转移瘤的CT表现及病理资料以提高对本病的诊断准确性。方法选取经病理证实为"肺转移,源于直肠/结肠癌"结直肠癌患者42例进行研究,所有病例均进行胸腹部CT增强扫描,重点对胸部病灶部位、大小、形态、边缘及内部密度等影像特征进行观察。结果 90%原发灶T分期为T3或T4,10例(24%)肺内出现超过3个以上病灶,表现为大小不等多发结节影,其中3例合并肺门淋巴结肿大;而例32(76%)表现为单发(26例)或2枚(6例)病灶,均表现为实性结节,其中97%病灶最大径>1 cm,66%～87%病灶出现分叶、边缘不规则或短毛刺等的征象,仅26%病灶具有长毛刺, 92%病灶呈不均匀强化,无1例出现支气管含气征和同侧肺门淋巴结肿大。结论结直肠癌肺转移的CT表现多样,熟悉结直肠癌肺转移的CT特征和易发因素对提高直结肠癌多学科会诊的TMN分期具有一定意义。Objective To review the CT findings and pathological data of lung metastases from rectal and colon cancer, so as to improve the diagnostic accuracy. Methods 42 cases of lung metastasis from colorectal cancer pathologically confirmed were underwent thoracic and abdominal CT enhanced scan and the size, shape, edge and internal density and other image features of chest lesions were observed. Results 90.4% of the primary tumors had T staging of T3 or T4,10 cases （23.7%） with more than 3 lesions in the lungs, showing multiple nodules with different sizes, including hilar lymph nodes enlargement in 3 cases. And 32 （76.3%） cases showed solitary （26 cases） or two （6 cases） lesions were solid nodules,of which 97.4% lesions＇ maximum diameters were more than 1 centimeters, 65.6- 86.8% lesions could appear signs of leaf, irregular edges or short burr etc, and 91.6% lesions showed heterogeneous enhancement. At the same time, only 26% lesions had long thorn, no cases had bronchial gas syndrome or ipsilateral hilar lymph nodes. Conclusion The CT appearances of Pulmonary metastasisfrom colorectal cancer were diversed. Mastering the CT features and predisposing factors of lung metastasis from colorectal cancer would benefit to TMN staging of multidisciplinary consultation of colorectal cancer.

关 键 词：结直肠肿瘤 肺肿瘤 肿瘤转移 体层摄影术 X线计算机 

分 类 号：R735.34[医药卫生—肿瘤] R730.44[医药卫生—临床医学]