囊腔类肺癌的多层螺旋计算机断层成像表现  

Multi slice computed tomography features of cystic lung cancer

作　　者：陈佳[1] 文利[1] 龚明福[1] 戴书华[1] Chen Jia;Wen li;Gong Mingfu;Dai Shuhua(Department of Radiology,Xinqiao Hospital,Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学(第三军医大学)新桥医院放射科,重庆400037

出　　处：《中华肺部疾病杂志（电子版）》2018年第5期551-554,共4页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家自然科学基金资助项目(81501521)

摘　　要：目的探讨囊腔类肺癌的多层螺旋计算机断层成像(MSCT)表现,提高对该病早期诊断准确率。方法回顾性分析27例经手术或穿刺病理证实的孤立性囊腔类肺癌的临床资料及MSCT表现,并根据壁结节与囊腔关系对病灶进行分型;分型标准为:Ⅰ型:结节位于腔外;Ⅱ型:结节位于腔内;Ⅲ型:囊腔壁环状增厚;Ⅳ型:结节与多发含气腔隙混合。结果 27例患者中鳞癌4例,小细胞癌1例,腺癌22例。囊腔类肺癌病灶可呈现出不同的形态,包括分叶状9例、圆形/椭圆形15例和不规则形3例。囊腔平均最大径为26.9 mm,距胸膜最近平均距离18.8 mm。囊腔壁厚薄不均26例,平均厚度为2.5 mm,其中2例囊壁可见钙化灶。27例均可见壁结节影,壁结节最大径平均为16.2 mm。Ⅰ型、Ⅱ型、Ⅲ型和Ⅳ型病例分别有16例、3例、6例和2例,囊壁平均厚度分别为1.73 mm、2.63 mm、3.17 mm、2.13 mm。不同分型病灶的毛刺分布也存在差别,其中无毛刺Ⅰ型8例、Ⅱ型2例、Ⅲ型1例、Ⅳ型1例。毛刺局限在壁结节旁仅Ⅰ型6例,毛刺围绕整个病灶Ⅰ型2例、Ⅱ型1例、Ⅲ型5例、Ⅳ型1例。囊腔位于壁结节外侧11例,内侧9例,结节位于中间1例。16例囊腔内有分隔(59.2%),10例有血管穿行(37.0%)。可观察血管集束征13例(48.1%),短毛刺15例(55.6%),胸膜凹陷征9例(33.3%),7例病灶周围可见磨玻璃影(25.9%)。结论囊腔类肺癌的MSCT表现具有一定特征性,仔细分析囊腔特点及其周围表现,有助于提高早期诊断准确率。Objective To analyze the multi-slice computed tomography （MSCT） performance of cysticlung cancer and improve the accuracy of early diagnosis of the disease. Methods The clinical data and MSCTfindings of 27 cases of isolated cystic lung cancer confirmed by surgery or pathology were retrospectivelyanalyzed. According to the relationship between wall nodule and cyst, the lesions were classified into four types：Ⅰ： nodules located outside the cavity; Ⅱ： nodules located in the cavity; Ⅲ： cavity have a annular thick wall;Ⅳ： nodules coexist with multiple air space. Results There were 4 cases of squamous cell carcinoma, 1 case ofsmall cell lung cancer, 22 cases of adenocarcinoma, out of 27 enrolled cases. The lesions showed differentmorphologies, including lobulated 9 cases, rounded / oval 15 cases and irregularly shape 3 cases. The averagediameter of the cyst was 26.9 mm and the average distance from the pleura was 18.8 mm. Cyst wall thicknesswas uneven in 26 cases, and the average thickness was 2.5 mm, of which 2 cases of calcification can be seen.All the cysts showed the wall nodules in the 27 cases, and the average maximum diameter of the wall nodulewas 16.2 mm. There were 16 cases, 3 cases, 6 cases and 2 cases classified into type Ⅰ, type Ⅱ, type Ⅲ andtype Ⅳ respectively whose average wall thickness were 1.73 mm, 2.63 mm, 3.17 mm, and 2.13 mm. Therewere differences in spicule distribution between different types, including 8 cases of type Ⅰ, 2 cases of typeⅡ, 1 case of type Ⅲ and 1 case of type Ⅳ. Only 6 cases of type I showed spicules confined nearby the muralnodule, while 2 cases of type Ⅰ, 2 cases of type Ⅱ, 5 cases of type Ⅲ and 1 case of type Ⅳ showed spiculesaround the whole lesion. 11 cases had cysts locate outside the mural nodule, while 9 cases had cysts locate inside the mural nodule and 1 case had mural nodule locate in the middle. 16 cases （59.2%） had separation,10 cases （37.0%） had vascular pass through. 13 cases （48.1%） showed vessel convergence

关 键 词：支气管肺癌 囊腔 多层螺旋计算机断层成像 表现 

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