周围型小肺癌32例胸部多层螺旋CT影像分析

摘要

目的：分析总结周围型小肺癌胸部CT影像学特点，以期提高周围型小肺癌的早期影像诊断水平。方法：回顾性分析笔者所在医院2011年3月-2014年6月收治的32例经手术病理证实直径≤3 cm周围型小肺癌的胸部CT影像学资料，全部病例术前均行多层螺旋CT扫描，部分病例行MPR处理，其中行HRCT扫描10例，增强扫描22例。结果：具有胸部CT影像学特点分叶征27例，尖刺征25例，胸膜脐凹征18例，血管纠集征16例，空泡征7例，磨玻璃征5例，无任何特征小结节影3例，在22例增强扫描病例中，18例肺癌强化高峰强化值>17 Hu，有4例由于其强化效果及形态特征不典型而误诊为结核球、炎性假瘤、良性结节。结论：胸部多层螺旋CT扫描与HRCT相结合或增强扫描，根据其形态特征和强化方式以及临床资料等综合分析对提高周围型小肺癌的诊断正确率有重要帮助。%Objective:To analyze and summarize the CT chest imaging features of small peripheral lung cancer,in order to improve the early imaging diagnosis level of small peripheral lung cancer.Method:The clinical data of chest CT images of 32 cases of diameter≤3 cm small peripheral lung cancer proved by operation and pathology were analyzed retrospectively.All patients underwent multi-slice spiral CT scanning,part of patients underwent MPR treatment,the HRCT scanning in 10 cases,22 cases with enhanced scan.Result:The features of lobulation in 27 cases with chest CT images,spiked syndrome in 25 cases, pleural umbilical fossa syndrome in 18 cases,vascular convergence sign in 16 cases,vacuole sign in 7 cases,ground glass opacity in 5 cases,without any feature of small nodules in 3 cases,in 22 cases with enhanced scan,there were 18 cases of lung cancer with strengthening peak enhancement value>17 Hu, there were 4 cases because of its strengthening effect and morphological features of atypical and misdiagnosed as tuberculoma,inflammatory pseudotumor,benign nodules.Conclusion:Multi slice spiral CT scanning combined with HRCT or enhanced scanning,according to the comprehensive analysis and strengthening its morphological characteristics and clinical data to improve the diagnosis of correct rate in small peripheral lung cancer has an important role.