肺浸润性黏液腺癌的CT征象及病理特征分析  

CT features of invasive mucinous adenocarcinoma of the lung

作　　者：平小夏[1] 孟倩[1] 姜楠[1] 胡粟[1] PING Xiaoxia;Meng Qian;JIANG Nan;HU Su(Department of Radiology,The First Affiliated Hospital of Soochow University,Jiangsu 215000,China)

机构地区：[1]苏州大学附属第一医院放射科,江苏苏州215000

出　　处：《影像诊断与介入放射学》2023年第6期403-407,共5页Diagnostic Imaging & Interventional Radiology

摘　　要：目的分析原发性肺浸润性黏液腺癌(IMA)的CT表现,并结合临床及病理特征分析,以提高诊断水平。方法回顾性分析2016年1月—2021年9月确诊的154例IMA患者的临床表现、实验室检查及影像学资料。影像学评估内容包括病灶的部位、分布、大小、形态、密度、内部征象、边缘征象、与胸膜的关系,有无纵隔及肺门淋巴结肿大、胸腔积液,病灶的强化方式、程度及有无血管造影征。结果154例IMA中结节/肿块型134例,炎症型20例。病灶主要分布于双肺下叶(分别占比52.98%、70%),炎症型IMA的病变范围较结节/肿块型广泛(P=0.006),平均径线更大(P<0.001),炎症型病灶内空洞/空泡、充气支气管、血管造影征及晕征出现率较结节/肿块型高(P值分别为0.005、<0.001、0.004、<0.001);2组病例在平扫及增强CT值、分叶征、血管集束征、胸膜凹陷征及钙化之间均无明显统计学差异(P值均>0.05)。结论肺IMA好发于双肺下叶,平扫CT值较低,增强后多为轻度强化(强化幅度<20 HU),病灶内部可见空洞/空泡、充气支气管、血管造影征,边缘可见晕征及肺叶膨隆征,有助于临床诊断。Objective To analyze the CT appearance of primary invasive mucinous adenocarcinoma(IMA)of the lung in conjunction with its clinical and pathological features.Methods The clinical,laboratory and imaging data of 154 patients with IMA diagnosed between January 2016 and September 2021 were analyzed retrospectively.CT imaging evaluation included the tumor location,distribution,size,morphology,density,internal signs,marginal signs,relationship with the pleura,any mediastinal or hilar lymphadenopathy,pleural effusion,degree and pattern of contrast enhancement.Results The 154 IMA presented as lung nodule/mass(134)or inflammation(20)most commonly in both lower lobes.Inflammatory IMA was significantly more extensive(P=0.006)and larger(P<0.001)than the nodular/mass type.The inflammatory type had significantly higher rate of cavitation(P=0.005),air bronchogram(P<0.001),angiographic sign(P=0.004),and halo sign(P<0.001)than the nodular/mass type.There were no significant differences in CT values,lobar signs,vascular cluster signs,pleural depression signs,or calcifications(all P>0.05).Conclusion Pulmonary IMA is more common in the lower lobes with low CT values on unenhanced scan and mild enhancement.The CT features including cavitation,air bronchogram,and angiographic signs inside the lesions,halo signs and lobe expansion signs in the periphery can aid diagnosis.

关 键 词：肺癌 黏液腺癌 体层摄影术 X线计算机 病理特征 

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