原发性肺黏液腺癌的CT和MRI表现  

CT and MRI Findings of Primary Pulmonary Mucinous Adenocarcinoma

作　　者：谢青[1] 任彤 邹珏[2] 赵瑞芬[1] XIE Qing;REN Tong;ZOU Jue;ZHAO Ruifen(Department of Radiology,Nanjing Chest Hospital,Nanjing 210036,China;不详)

机构地区：[1]南京市胸科医院放射科,江苏南京210036 [2]南京市胸科医院病理科,江苏南京210036

出　　处：《中国医学影像学杂志》2022年第8期790-794,共5页Chinese Journal of Medical Imaging

摘　　要：目的 结合病理探讨原发性肺黏液腺癌(PPMA)的CT和MRI表现。资料与方法 回顾性分析南京市胸科医院2018年1月—2020年12月经手术病理或穿刺活检证实的30例PPMA的临床及影像资料,结合病理分析其CT和MRI表现。结果 30例患者中,26例表现为结节/肿块型,4例表现为实变型。26例结节/肿块型CT表现为直径0.7~5.8 cm,分叶征14例,毛刺征9例,胸膜凹陷9例,空泡/假空洞征8例,支气管充气征11例。病灶周围见磨玻璃影11例。结节/肿块实性区平扫平均CT值(35.3±4.1)Hu,10例CT增强扫描中4例可见强化血管影穿行。4例实变型CT表现为病灶密度偏低4例,边缘模糊3例,支气管充气征3例,实变周围多发磨玻璃影4例,2例行增强扫描均可见血管造影征。病灶直径>2 cm的15例患者行MRI扫描,11例结节/肿块型病灶T1WI均呈等信号,4例T2WI呈均匀高信号,4例呈稍高信号,3例呈等高混杂信号。4例实变型病灶T1WI呈等信号,T2WI呈大片高信号,T2WI-spc呈高信号,呈“白肺征”。结论 原发性肺黏液腺癌CT表现为密度偏低的结节肿块或大片实变,毛刺细软及胸膜凹陷轻微,空泡/假空洞征及支气管充气征、血管造影征多见。CT征象结合MRI“白肺征”,为肺黏液腺癌的早期诊断提供影像依据。Purpose Combined with pathology, to investigate CT and MRI findings of primary pulmonary mucinous adenocarcinoma(PPMA). Materials and Methods The clinical and imaging data of 30 patients with PPMA confirmed by surgery or needle biopsy in Nanjing Chest Hospital from January 2018 to December 2020 were collected. CT and MRI findings of PPMA were retrospectively analyzed and compared with pathology. Results Among 30 cases, nodule and mass types were found in 26 cases, consolidation types were found in 4 cases. In 26 nodule and mass types, the diameter ranged from 0.7 to 5.8 cm, lobulation sign were found in 14 cases, spicule sign in 9 cases,pleural indentation sign in 9 cases, vacuole/pseudocavity sign in 8 cases, air bronchogram sign in 11 cases, ground-glass opacities sign around the lesion in 11 cases. Twenty-six nodule and mass lesions showed low density [average(35.3±4.1) Hu]. Ten cases underwent enhanced scan, angiogram sign was found in 4 cases. In 4 consolidation types, the lesions showed low density, and blurry margin in 3 cases,air bronchogram sign in 3 cases, ground-glass opacities sign around the consolidation in 4 cases. Angiogram sign were found on both contrast-enhanced scans. Among the 30 patients, MRI sans were performed in 15 patients with lesions larger than 2 cm in diameter. In 11nodule and mass types, all the lesions showed isointensity on T1WI, 4 cases showed significantly high intensity on T2WI, 4 cases showed slightly high intensity on T2WI, and 3 cases showed mixed signal. In 4 consolicaton types, the lesions showed isointensity on T1WI,significantly high intensity on T2WI and T2WI-spc(white lung sign). Conclusion Primary lung mucinous adenocarcinoma has certain imaging manifestations: nodule/mass or consolication with low density, less spicule sign and pleural indentation sign, more vacuole/pseudocavity sign, air bronchogram sign and angiogram sign. CT signs combined with MRI “white lung sign” provide imaging basis for early diagnosis of lung mucinous adenocarcinoma.

关 键 词：肺腺癌 黏液 体层摄影术 X线计算机 磁共振成像 病理学 外科 

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