多层螺旋CT鉴别孤立型肺黏液腺癌与非黏液浸润性腺癌的应用价值  

Application Value of Multislice Spiral CT in Differentiating Isolated Pulmonary Mucinous Adenocarcinoma from Nonmucinous Invasive Adenocarcinoma

作　　者：赵利芳 钱伟军 李立 赵文 杨洁 ZHAO Li-Fang;QIAN Wei-jun;LI Li;ZHAO Wen;YANG Jie(Department of Imaging,Kaifeng Central Hospital,Kaifeng 475000,Henan Province,China;Department of Imaging,The First Affiliated Hospital of Henan University,Kaifeng 475000,Henan Province,China)

机构地区：[1]河南省开封市中心医院影像科,河南开封475000 [2]河南大学第一附属医院影像科,河南开封475000

出　　处：《中国CT和MRI杂志》2023年第10期74-76,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨孤立型肺黏液腺癌(SPMA)与非黏液侵润性肺腺癌(NMIPA)的CT征象的鉴别,以提高术前SPMA诊断及鉴别诊断。方法搜集本院2017年8月-2022年8月经手术或穿刺活检病理证实SPMA(40例)和NMIPA(50例)的临床及CT资料,对比分析两组患者的临床及CT征象。结果两组患者的性别及年龄对比无统计学意义(P>0.05)。SPMA及NMIPA分叶征、毛刺、纯磨玻璃密度、空泡征、平扫肺窗最大直径差异无统计学意义(P>0.05)。SPMA组发生在双肺下叶、边缘模糊、混合磨玻璃密度、钙化、空气支气管征、瘤周卫星灶、血管造影征、无强化坏死区、Δ病灶直径差值(mm)均高于NMIPA组,差异有统计学意义(P<0.05)。SPMA发生在双肺上中叶、边缘清晰、实性密度、胸膜牵拉征、转移、平扫纵隔窗最大直径(mm)、Δ动、静脉期低于NMIPA组,差异有统计学意义(P<0.05)。结论SPMA及NMIPA的CT征象存在一定的差异,双肺下叶、混合磨玻璃密度为主、边缘模糊、钙化、空气支气管征、瘤周卫星灶、Δ病灶直径差值(mm)大、增强呈轻度强化、血管造影征、无强化坏死区有助于SPMA诊断及鉴别诊断。Objective To explore the differentiation of CT signs between isolated pulmonary mucinous adenocarcinoma(SPMA)and non-mucinous pulmonary adenocarcinoma(NMIPA)in order to improve preoperative diagnosis and differential diagnosis of SPMA.Methods Clinical and CT data of SPMA(40 cases)and NMIPA(50 cases)confirmed by surgery or puncture biopsy in our hospital from August 2017 to August 2022 were collected.The clinical and CT signs of the two groups were compared and analyzed.Results There was no statistical significance in gender and age between the two groups(P>0.05).There were no significant differences in SPMA and NMIPA foliation,burr,pure ground glass density,vacuole sign and maximum diameter of lung window under plain scan(P>0.05).SPMA group was higher than NMIPA group in lower lobes of both lungs,margin blur,mixed ground glass density,calcification,air bronchial signs,peritumoral satellite foci,angiography signs,no enhanced necrotic areas,andδfocus diameter difference(mm),with statistical significance(P<0.05).SPMA occurred in the upper and middle lungs of both lungs,with clear edges,solid density,pleural drawing sign,metastasis,maximum diameter of mediastinal window(mm)on plain scan,and the motor and venous stages ofδT were lower than those in the NMIPA group,with statistical significance(P<0.05).Conclusion The CT signs of SPMA and NMIPA are different to some extent.The lower lobes of the two lungs,mixed ground glass density,blurred edges,calcification,air bronchial signs,peritumoral satellite foci,large diameter difference ofδfocus(mm),mild enhancement,angiographic signs,and no enhanced necrotic areas are helpful for the diagnosis and differential diagnosis of SPMA.

关 键 词：肺黏液腺癌 非黏液腺癌 CT征象 鉴别诊断 

分 类 号：R8[医药卫生—临床医学]