囊腔型肺癌的CT特征分析  

CT Manifestation Characteristics Analysis of Cystic Lung Cancer

作　　者：王文轩 樊幼林 蒋炳虎 郭志伟 张福洲 WANG Wen-xuan;FAN You-lin;JIANG Bing-hu;GUO Zhi-wei;ZHANG Fu-zhou*(Department of Imaging,Nanchong Central Hospital,Nanchong 637000,Sichuan Province,China)

机构地区：[1]南充市中心医院医学影像科,四川南充637000

出　　处：《中国CT和MRI杂志》2024年第12期54-56,共3页Chinese Journal of CT and MRI

基　　金：川北医学院2023年度四川省基层卫生事业发展研究中心资助项目(SWFZ23-Y-46)。

摘　　要：目的分析囊腔型肺癌的多层螺旋CT诊断特征,以提高诊断的准确率。方法对病理证实的20例囊腔型肺癌的CT影像特征进行回顾分析。结果20例囊腔型肺癌均为单发病例,右肺13例,左肺7例,其中17例腺癌,3例鳞癌,多为椭圆形(65%)。影像特征:分叶征(85%)、毛刺征(75%),肺瘤界面模糊(85%),多囊(60%),囊内多发分隔(60%),囊内结节(30%),囊外结节(20%),囊壁粗糙(90%),腔内无血管形成(70%),有胸膜凹陷征(70%),无卫星灶(90%),无强化(90%),无钙化(100%),无支气管截断(70%),无转移(70%),形态分型以Ⅲ型为多(40%)。20个病灶大小范围8.0mm-71.1mm,平均35.3mm;囊腔大小5.0mm-57.0mm,平均26.4mm;囊壁厚度范围1.0mm-3.7mm,平均2.4mm。10例动态随访病例中,7表现为壁结节增大或囊腔增大或囊壁增厚或周围晕征增大或胸膜受累加重,2例囊腔消失代之实性成分,1例变化不明显。结论囊腔型肺癌CT表现有一定特征性,当肺内囊腔样结构出现囊壁增厚、囊壁不规则、囊内分隔、囊壁结节、囊周边界模糊等征象时,应警惕囊腔型肺癌的可能。Objective Analyze the multi-slice spiral CT features and differential diagnosis of cystic lung cancer to improve diagnostic accuracy.MethodsRetrospective analysis of CT features in 20 cases of cystic lung cancer confirmed by pathology.Results20 cases of cystic lung cancer were all single cases,with 13 cases in the right lung and 7 cases in the left lung,including 17 cases of adenocarcinoma and 3 cases of squamous cell carcinoma.The morphology is mainly type III.The shape is mostly elliptical(65%),with lesion edge lobulation sign(85%)and spiculation sign(75%),blurred lung tumor interface(85%),polycystic(60%),multiple fibrous septations within the cyst(60%),intracystic nodules(30%),extracystic nodules(20%),rough cyst wall(90%),no blood vessel formation in the cavity(70%),pleural indentation sign(70%),no satellite lesions(90%),no enhancement(90%),and no calcification(100%),No bronchial truncation(70%),no metastasis(70%),and morphological classification is more common in type III(40%).20 lesions ranging in size from 8.0mm to 71.1mm,with an average of 35.3mm;The size of the cyst cavity is 5.0mm~57.0mm,with an average of 26.4mm;The thickness range of the cyst wall is 1.0mm~3.7mm,with an average of 2.4mm.Among the 10 dynamic follow-up cases,7 showed enlargement of wall nodules or cystic cavity,thickening of cyst wall,enlargement of peripheral halo signs,or worsening of pleural involvement.2 cases had cystic cavity disappearance replacing solid components,and 1 case had no significant changes.ConclusionThe CT manifestations of cystic lung cancer have certain characteristics.When the cystic like structure in the lung shows signs such as thickening of the cyst wall,irregularity of the cyst wall,intracystic septa,nodules on the cyst wall,and blurred pericystic boundaries,caution should be exercised against the possibility of cystic lung cancer.

关 键 词：肺癌 囊腔 多层螺旋CT 诊断 鉴别诊断 

分 类 号：R563[医药卫生—呼吸系统]