肺炎型黏液腺癌的CT表现  

The CT manifestations of pneumonia type mucinous adenocarcinoma

作　　者：吕长磊[1] 刘乐[2] 陈小龙[1] 黄明刚[1] 齐敏[1] 张国平[1] LüChanglei;LIU Le;CHEN Xiaolong;HUANG Minggang;QI Min;ZHANG Guoping(CT Room,Shaanri Provincial People's Hospital,Xi'an 710068,China;Department of Imaging,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]陕西省人民医院CT室,陕西西安710068 [2]西安交通大学第二附属医院影像科,陕西西安710004

出　　处：《实用放射学杂志》2022年第11期1775-1778,共4页Journal of Practical Radiology

摘　　要：目的探讨肺炎型黏液腺癌(PTMA)CT特征.方法回顾性选取经手术或肺穿刺活检病理证实的56例PTMA患者,均行CT平扫,其中25例行增强扫描.分析病灶分布、形态、密度、边缘边界、空气支气管征、空泡或空洞征、强化程度、血管造影征和肺内转移的CT表现.结果56例PTMA表现为局灶性或弥漫性混合磨玻璃影和气腔实变.多叶性、多灶性和双肺受累占67.9%,周围伴有边界清楚磨玻璃影占67.9%,多发结节占66.1%.动态观察磨玻璃影和结节病灶融合、增多、实变并向两肺播散.病灶边缘光滑平直伴直角征占76.8%,叶间裂膨隆占42.9%,“枯树枝样”空气支气管征占55.4%,实变内伴多发空泡或空洞占66.1%.病灶密度较低(平均24.5HU±8.4HU),增强后多呈不均匀轻度强化(平均41.1HU±16.6HU)伴血管造影征.仅有2例出现胸水,2例见胸膜和纵隔淋巴结转移.结论PTMA特征性CT表现为“枯树枝样”空气支气管征、CT血管造影征、多发空泡或空洞征、边缘平直伴直角征、叶间裂膨隆和气腔内播散.Objective To investigate the CT features of pneumonia type mucinous adenocarcinoma(PTMA).Methods A total of 56 patients with PTMA confirmed by surgery or lung biopsy were analyzed retrospectively.All patients underwent CT plain scan,of which 25 cases underwent enhanced CT scan.The CT manifestations of lesion distribution,shape,density,marginal boundary,air bronchogram sign,vacuole or cavity sign,enhancement degree,angiogram sign and intrapulmonary metastasis were analyzed.Results 56 cases of PTMA showed focal or diffuse mixed ground glass and air-space consolidation.Multilobar,multifocal and bilateral lung involvement accounted for 67.9%,peripheral ground glass opacity with well-defined accounted for 67.9%,and multiple nodules accounted for 66.1%.Dynamic observation found that the ground glass lesions and nodular lesions fused,enlarged,consolidated and disseminated to both lungs.Lesions with straight and smooth margin accompanied by right angle sign accounted for 76.8%,bulging of the interlobar fissure accounted for 42.9%,"withered tree like"air bronchogram sign accounted for 55.4%,and multiple vacuoles or cavities accounted for 66.1%.All lesions showed low density(mean 24.5 HU±8.4 HU).Most of them showed heterogeneous mild enhancement(mean 41.1 HU±16.6 HU)with angiogram sign.Only 2 cases had pleural effusion and 2 cases had pleural and mediastinal lymph node metastasis.Conclusion"Withered tree like"air bronchogram sign,CT angiogram sign,multiple vacuoles or cavities sign,straight edge with right angle sign,bulging of the interlobar fissure and spread through air spaces are characteristic findings of PTMA.

关 键 词：肺炎型黏液腺癌 肺癌 计算机体层成像 

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