T1a 与 T1b 期周围型肺癌MSCT 征象检出率的差异

摘要

Objective To evaluate the detection rate of multi-slice spiral CT (MSCT)signs and the clinical value of multi-planar reconstruction (MPR)in T1a and T1b peripheral lung cancer patients.Methods Eighty-seven cases with peripheral lung cancer proved by pathology were collected.The cases were divided into T1a and T1b group based on the TNM classification.The MSCT and MPR images were compared between the two groups.Results (1)Detection rate of the deep sublobe sign,spinous process sign, short spiculated sign,pleural indentation sign,vascular convergence sign,multi-nodule accumulation sign,vacuole sign and air bron-chogram sign,were 1 1.4%,20.0%,31.4%,60.0%,25.7%,45.7%,42.9% in T1a group and 42.3%,36.5%,57.7%, 80.8%,5 1.9%,25.0%,21.2% in T1b group,respectively.The difference were all statistically significant (P < 0.05)between T1a and T1b group except that of the spiculated sign (P = 0.098).(2)The detection rate of the sublobe sign,spinous process sign, spiculated sign,pleural indentation sign and vascular convergence sign were higher on MPR images than on axial thin-slice images in both T1a and T1b group.Conclusion The detection rate of the tumor-lung interface’s signs are lower in T1a than in T1b,the detec-tion rate of internal structure signs of the tumor are higher in T1a than in T1b in peripheral lung cancer patients.MPR has important value in early diagnosis of peripheral lung cancer.%目的：探讨 T1a、T1b 期周围型肺癌的 MSCT 常见征象检出率的差异及 MPR 的应用价值。方法收集87例经病理证实的周围型肺癌,并按 TNM 分期分为 T1a、T1b 期2组,对比其 MSCT 横断面和 MPR 图像。结果(1)深分叶征、棘突征、短毛刺征、胸膜凹陷征、血管集束征、多结节聚合征、空泡/细支气管充气征的检出率 T1a 组分别为11.4%、20.0%、31.4%、60.0%、25.7%、45.7%、42.9%,T1b 组分别为42.3%、36.5%、57.7%、80.8%、51.9%、25.0%、21.2%。除棘突征(P =0.098)外,它们的差别都有统计学意义(P <0.05)。(2)T1a、T1b 组分叶征、棘突征、毛刺征、胸膜凹陷征、血管集束征的检出率在 MPR 图像上均高于横断面。结论瘤-肺交界面征检出率在 T1a 期周围型肺癌低于 T1b 期,瘤体内部征象的检出率在 T1a 期更高。MPR 对早期周围型肺癌的诊断有价值。