原发性气管黏液表皮样癌的CT表现  

CT findings of primary tracheal mucoepidermoid carcinoma

作　　者：莫森林 胡若凡[2] 胡海菁 倪志文 黄绥丹 赖文佳 陈淮[3] MO Senlin;HU Ruofan;HU Haijing;NI Zhiwen;HUANG Suidan;LAI Wenjia;CHEN Huai(Department of Radiology,the Affiliated Nanhai Hospital of Southern Medical University,Foshan,Guangdong Province 528200,China;Department of Radiology,the Second People's Hospital of Shenzhen,Shenzhen,Grangdong Province 518035,China;Department of Radiology,the First Affiliated Hospital of Guangzhou Medical Uhiversity,Guangzhou 510120,China)

机构地区：[1]南方医科大学附属南海医院放射科,广东佛山528200 [2]深圳市第二人民医院放射科,广东深圳518035 [3]广州医科大学附属第一医院放射科,广东广州510120

出　　处：《实用放射学杂志》2021年第2期211-215,共5页Journal of Practical Radiology

基　　金：广东省普通高校特色创新类项目(2018KTSCX188);佛山市卫生健康局医学科研课题项目(20200381);佛山市“十三五”医学特色专科建设项目(FSTSZK011).

摘　　要：目的探讨原发性气管黏液表皮样癌(PTMEC)的CT表现,提高对本病的诊断及鉴别诊断水平。方法回顾性分析11例经病理确诊为PTMEC的患者资料,总结其CT表现。结果所有病灶均为单发病灶,最大径8~40 mm,平均(19.6±8.1)mm,其中10例(90.9%)最大长径<30 mm。发生在上段、中段、下段者分别为1例(9.1%)、3例(27.3%)、7例(63.6%)。累及气管两侧壁及后壁8例(72.7%),仅累及软骨部3例(27.3%)。病灶完全位于气管腔内8例(72.7%),呈宽基底结节;同时累及气管腔内、外3例(27.3%),呈宽基底不规则或类圆形结节或肿块,其中2例(18.2%)腔内部分较腔外部分大,1例(9.1%)腔外部分略大于腔内部分。3例(27.3%)病灶最大长径与气管长轴平行,11例(100%)边界清晰,9例(81.8%)可见分叶,8例(72.7%)密度均匀,3例(27.3%)灶内见局限低密度影,1例(9.1%)见斑点状钙化灶。增强扫描呈均匀或不均匀中度至明显强化,8例(72.7%)表现为明显强化,3例(27.3%)表现为中度强化。增强扫描与平扫CT值的差值平均增加(50.6±21.0)HU。3例(27.3%)伴肺泡积血。所有病例未发现阻塞性肺气肿、肺炎、肺不张、支气管扩张、黏液栓、纵隔移位、胸腔积液、肺门及纵隔淋巴结肿大、远处转移等征象。结论当发现年轻患者气管后壁及两侧壁的腔内或腔内外宽基底结节、相应肺阻塞征象较少、增强扫描呈中度至明显强化时,应考虑到PTMEC可能,确诊需病理学检查。Objective To investigate the CT findings of primary tracheal mucoepidermoid carcinoma(PTMEC)and to improve the level of diagnosis and dffential diagnosis of this disease.Methods The data of 11 patients with PTMEC confirmed by pathology were analyzed retrospectively,and their CT findings were summarized.Results All the lesions were single lesion,with a maximum length-diameter of 8 mm-40 mm and an average of(19.6±8.1)mm,of which 10 cases[90.9%]had a maximum length-diameter less than 30 mm.The number of lesions occurred in the upper,middle and lower segments was 1 case(9.1%),3 cases(27.3%)and 7 cases(63.6%),rspectively.The bilateral walls or posternior wall of the trachea were involved in 8 cases(72.7%),and only the cartilage was involved in 3 ases(27.3%).The lesions were completely located in the tracheal lumen in 8 cases(72.7%)showing nodules with wide base.Extra-and intra-luminal was involved in 3 ases(27.3%)ishowing irregular or round-like nodules or masses with wide base,of which the.itroluminal part was larger than the extraluminal part in 2 ases(18.2%),and the extraluminal part was sighly larger than the ntraluminal part in 1 case(9.1%).The maximum kength of the lesion was parallel to the long axis of the trachea in 3 cases(27.3%),the boundary wasclearin 11 cases(100%)。lobulation was seen in 9 cases(81.8%),homogeneous density in 8 cases(72.7%),localized low density shadow in 3 cases(27.3%)and spotted calcification in 1 ase(9.1%).The enhanced scan showed uniform or inhomogeneous moderate-obvious enhancement,including obvious enhancement in 8 ases(72.7%)and moderate enhancement in3 ases(27.3%).The average CT value difference between the enhanced and the plain scan was(50.6±21.0)HU3 ases(27.3%)were complicated with alveolar hemorrhage.No signs of obstructive emphysema,pneumonia,atelectasis,bronchiectasis,mucus plugs,mediastinal shift。pleuraleffusion.hilar and mediastinal lymph nodes enlargement and distant metastasis were found.Condusion When it is found that the intraluminal or extrar and intrar luminal n

关 键 词：气管 气管黏液表皮样癌 计算机体层成像 

分 类 号：R734.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]