周围型肺类癌的CT表现及强化特点(附12例分析)  

CT manifestations and enhancement features of peripheral pulmonary carcinoid tumors(analysis of 12 cases)

作　　者：宋国栋 吴珍[2] 徐嘉雯 毕蕾 陈海荣 刘玉波 SONG Guodong;WU Zhen;XU Jiawen;BI Lei;CHEN Hairong;LIU Yubo(Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, P.R.China;Department of Respiratory, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, P.R.China;Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, P. R.China;Department of Inteasive Care Unit, The Friest Affiliated Hospital of Shandong First Medical University, Jinan 250014, P.R.China)

机构地区：[1]山东第一医科大学附属省立医院医学影像科,山东济南250021 [2]山东大学第二医院呼吸内科,山东济南250033 [3]山东第一医科大学附属省立医院病理科,山东济南250021 [4]山东第一医科大学第一附属医院重症医学科,山东济南250014

出　　处：《医学影像学杂志》2021年第12期2053-2056,2060,共5页Journal of Medical Imaging

基　　金：山东省医药卫生科技发展计划项目(编号:2019WS468)。

摘　　要：目的探讨周围型肺类癌的CT影像表现及强化特征,以提高对该病的认识。方法回顾性分析经病理证实的12例周围型肺类癌的CT资料,观察病变的CT征象并文献复习。结果12例患者中,6例典型类癌,6例不典型类癌;12例均行胸部CT扫描,其中增强扫描11例,平扫1例;病变均表现为肺内单发周围性结节或肿块,平均大小约2.4 cm(范围1.8~4.4 cm),10例病变边界清晰并伴有分叶。平扫密度均匀者10例,伴钙化者2例,另2例伴肺门淋巴结肿大;增强扫描显示,9例呈中度-明显均匀强化,2例为轻度强化;病变与邻近小支气管(10/12例)及血管(9/11例)关系密切,有7例见小支气管截断(7/12例),其远端呈支气管扩张或阻塞性改变。结论周围型肺类癌的CT表现有一定特征性,多为肺内边界清晰的、分叶状孤立性结节或肿块,增强扫描呈现明显强化,并与邻近血管及小支气管关系密切。熟悉周围型肺类癌的以上CT特征有助于鉴别诊断。Objective To explore the CT imaging features and enhancement features of peripheral pulmonary carcinoid tumors and to improve the understanding of this disease.Methods The CT imaging manifestations of 12 patients with pathologically proven peripheral pulmonary carcinoid tumors were retrospectively analyzed and literature review was performed.Results Among the 12 patients,6 cases were typical carcinoid and 6 cases were atypical carcinoid.There were 5 males and 7 females ranging from ages of 33 to 72 years old(median age 58 years old).Contrast-enhanced CT scans were performed in 11 patients,and non-enhanced CT scan was performed in one patient.All lesions presented as solitary pulmonary peripheral nodules or masses,with an average size of about 2.4 cm(range from1.8 to 4.4 cm).The lesions were well-defined and lobulated in 10 cases.Non-enhanced CT images showed homogeneous density in 10 cases,calcification in two cases,and hilar lymph node enlargement in two cases.Contrast-enhanced scanning showed moderate to obvious uniform enhancement in 9 cases and mild enhancement in two cases.Most of the lesions were closely related to the adjacent small bronchi(10/12 cases)and blood vessels(9/11 cases).Some small bronchi were occluded(7/12 cases),and distal bronchiectasis or obstructive changes could be observed.Conclusion There are some CT characteristics of peripheral pulmonary carcinoid tumors,most of which are well-defined,lobulated solitary pulmonary nodules or masses with significant enhancement,and close relationship with adjacent blood vessels and small bronchi.Becoming familar with imaging characteristics above would be helpful for the differential diagnosis of peripheral pulmonary carcinoid tumors.

关 键 词：周围型肺类癌 孤立性肺结节 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]