肺内淋巴结的高分辨率CT影像表现  

High-resolution CT imaging findings of intrapulmonary lymph nodes

作　　者：陈旭 舒锦尔[1] 李惠民[2] 潘江峰[1] 王定君 王梦辰 施红旗[3] 李鲁[1] CHEN Xu;SHU Jin'er;LI Huimin;PAN Jiangfeng;WANG Dingjun;WANG Mengchen;SHI Hongqi;LI Lu(Department of Radiology,Jinhua Municipal Central Hospital,Jinhua 321000,China;Department of Radiology,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200002,China;Department of Pathology,Jinhua Municipal Central Hospital,Jinhua 321000,China)

机构地区：[1]金华市中心医院放射科,浙江金华321000 [2]上海交通大学医学院附属新华医院放射科,上海200092 [3]金华市中心医院病理科,浙江金华321000

出　　处：《实用放射学杂志》2020年第4期554-557,共4页Journal of Practical Radiology

基　　金：浙江省自然科学基金项目(LGF18H1800);金华市科技局重大专项项目(2017-3-004).

摘　　要：目的探讨经病理证实的肺内淋巴结(IPLN)的高分辨率CT(HRCT)影像表现,以提高IPIN的诊断水平及减少误诊.方法回顾性分析经手术病理证实的98例共117枚IPLN的影像资料.所有患者术前均经HRCT扫描并行1.0 mm薄层重建,采取双盲法观察IPLN的数目、位置、大小、形态等影像学特点.结果82例为单发,16例多发,其中13例2枚,3例3枚.108枚位于气管隆嵴水平以下,9枚位于隆嵴水平以上.90枚位于右肺(上叶20枚、中叶31枚、下叶39枚),27枚位于左肺(上叶3枚、下叶24枚).最大径3.0~10.4 mm,平均(5.7±1.8)mm.117枚IPLN均为实性结节,边界清晰,其中7枚可见钙化.60枚IPLN呈类圆形,12枚呈三角形,45枚呈多边形.106枚距离胸膜≤10 mm,其中37枚紧贴胸膜,27枚紧贴叶间裂,11枚距离胸膜>10 mm.100枚IPLN可见1条或多条线状影与邻近胸膜或(和)肺静脉相连.9枚行胸部CT增强扫描,3枚表现为持续强化,2枚未见强化,余4枚无法判断是否有强化.结论IPLN在HRCT上常表现为伴有线状影的胸膜下实性小结节,熟悉其影像特征,多数可做出正确的影像诊断.Objective To explore the high-resolution CT(HRCT)image features of intrapulmonary lymph nodes(IPLN)confirmed by pathology,to improve the diagnostic performance and reduce misdiagnosis.Methods Imaging data of 117 IPLN in 98 patients confirmed by surgery and pathology were reviewed retrospectively.All of the patients underwent HRCT scan with 1.0 mm thin layer reconstruction before operation.The number,location,size,morphology and other image features of IPLN were observed by double-blind method.Results 82 patients had single lesion,and 16 had multiple lesions with 2 lesions in 13 patients and 3 lesions in 3 patients.108 IPLN were below the level of tracheal carina,and 9 IPLN were above that.90 IPLN were in the right lung(20 in the upper lobe,31 in the middle lobe and 39 in the lower lobe)and 27 IPLN were in the left lung(3 in the upper lobe and 24 in the lower lobe).The range of the maximum diameters was between 3.0 to 10.4 mm with averaging(5.7±1.8)mm.All of the IPLN were solid nodules with clear boundary,and 7 of them showed calcification.There were 60 quasi-circular,12 triangular and 45 polygonal.The distance from the pleura was≤10 mm in 106 IPLN,of which 37 were close to the pleura,and 27 close to the interlobular fissure.il IPLN were at a distance from pleura>10 mm.1 or more linear shadows connected to adjacent pleura or(and)pulmonary veins in 100 IPLN.9 IPLN underwent enhanced chest CT scan with continuous enhancement in 3,no enhancement in 2 and the remaining 4 failed to be judged for cnhanccmcnt.Conclusion IPLN usually present as small solid subpleural nodules with linear shadows on HRCT.Mastering these image features can help to make correct diagnosis at most circumstances.

关 键 词：肺结节 肺内淋巴结 计算机体层成像 

分 类 号：R563.9[医药卫生—呼吸系统] R814.42[医药卫生—内科学]