小细胞肺癌患者CT表现特点及诊断分析  

CT Features and Diagnostic Analysis of Patients with Small Cell Lung Cancer

作　　者：王志芳[1] 张海深[1] 刘海燕 吕彦萍 褚相乐 王勇[1] WANG Zhi-fang;ZHANG Hai-shen;LIU Hai-yan;LV Yan-ping;CHU Xiang-le;WANG Yong(Department of Radiology,General Hospital of oilfield,Puyang City,Puyang 457001,Henan Province,China)

机构地区：[1]河南省濮阳市油田总医院放射科,河南濮阳457001

出　　处：《中国CT和MRI杂志》2023年第1期74-76,共3页Chinese Journal of CT and MRI

基　　金：2018年河南省医学科技攻关计划联合共建项目(2018021016)。

摘　　要：目的 探讨小细胞肺癌(SCLC)的典型CT表现,以提高对其诊断及认识。方法 选取2017年6月至2020年12月间经我院病理结果证实为小细胞肺癌的患者63例的影像资料及临床资料,对其CT平扫及增强图像征象进行分析。结果 63例SCLC患者平均年龄约60.2岁,CT影像显示,均为中央型SCLC,位于左肺门者49例,右肺门者14例;右下肺23例,左下肺27例;出现阻塞性肺炎者34例,阻塞性肺不张18例,出现“冰冻纵隔或冰冻肺门”者58例(占92%),心包积液15例,胸膜腔积液13例,远发转移24例:其中脑转移16例,肾上腺转移5例,骨转移3例。结论 典型的SCLC的CT表现具有一定的特征,多表现为肺门巨大肿块伴纵隔多发淋巴结肿大,呈“冰冻纵隔”表现,增强扫描肿物较小时时强化尚均匀,较大时可出现液化坏死,呈明显不均匀强化,SCLC侵袭性较高,疾病早期便可出现远处转移,较有特征性,确诊仍需结合病理检查。Objective To analyze the typical CT findings of small cell lung cancer(SCLC), so as to improve the diagnostic level and understanding of SCLC. Methods The imaging and clinical data of 63 patients with small cell lung cancer confirmed by pathological method of our hospital between June 2017 and December 2020 were selected, and then analyzed their CT plain scan and enhanced image. Results The average age of 63 SCLC patients was about 60.2 years old. CT showed that the patients were all central SCLC, 49 cases were located in the left hilum, 14 in the right;23 cases were in the right lower lung, and 27 cases in the left lower lung. There were 34 cases of obstructive pneumonia, 18 cases of obstructive atelectasis, 58 cases(92%) of "frozen mediastinum or frozen hilum", 15 cases of hydropericardium, 13 cases of hydrothorax, 24 cases of distant metastasis: 16 cases of brain metastasis, 5 cases of adrenal metastasis, 3 cases of bone metastasis. Conclusion The CT manifestationgs of typical SCLC have certain characteristics, most of which are huge hilar masses with multiple mediastinal lymphadenopathy, appearing as "frozen mediastinum". When it is small, SCLC shows an even enhancement,Liquefaction and necrosis may arise when the tumor becomes larger, with uneven enhancement. The disease is highly invasive. Distant metastasis may occur in the early stages of the disease. It is characteristic, and the diagnosis still needs to be combined with pathological examination.

关 键 词：小细胞肺癌 CT 肺肿瘤 影像表现 

分 类 号：R735.7[医药卫生—肿瘤]