孤立结节周围型肺癌的多层螺旋CT诊断

摘要

Objective To investigate the diagnostic value of multi-slice spiral computed tomography (MSCT) with multiple three-dimensional reconstruction methods in dealing with solitary nodule of peripheral lung cancer. Methods Forty-six patients who had solitary nodule of peripheral lung cancer with diamenter under 3 cm were ex-amined with MSCT at department of radiology in Jurong hospital from February 2009 to April 2014. All cases were confirmed by surgery and (or) CT-guided percutaneous lung biopsy and pathology. Results A total of 46 cases were recruited. Among them, pathological classifications were as follows:25 cases of adenocarcinoma, 11 cases of squamous carcinoma, 9 cases of small cell lung cancer and 1 case of undifferentiated cancer. MSCT found that 36 cases were with lobulation sign, 28 cases with burr sign, 13 cases with marginal speculated sign, 9 cases with vacuole sign,16 cases with pleural indentation sign,and 12 cases with vascularnotch sign. Additional enhanced CT scanning with the increasing range of 42 to 65 Hu were carried out on 11 cases. Conclusions Multiple three-dimensional reconstructed images of multi-slice spiral CT is able to increase the delineation of the tumoral findings,which is of great value in the diagnosis and differential diagnosis of solitary nodule of peripheral lung cancer.%目的：探讨多层螺旋CT对孤立结节周围型肺癌的诊断价值。方法回顾分析我院2009年2月至2014年4月46例经手术、穿刺活检病理证实，直径≤3 cm的肺内孤立结节周围型肺癌的多层螺旋CT征象进行分析和总结。结果46例肺内孤立结节周围型肺癌中，腺癌25例，鳞癌11例，小细胞癌9例，未分型癌1例。多层螺旋CT征象：分叶征36例（78％）；毛刺征28例（61％），短毛刺21例，长毛刺7例；棘状突起13例（28．3％）；空泡征9例（20％）；胸膜凹陷征16例（35％）；血管集束征12例（26％）。增强扫描11例，增强幅度42~65 Hu。结论多层螺旋CT三维重组，可以发现更多有诊断价值的CT征象，对孤立结节周围型肺癌的诊断与鉴别诊断具有较高的临床价值。