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多层螺旋CT对高危肺癌人群的筛查价值及影像表现分析

作者:陈 灿 周庆元 房 卿

所属单位:西安交通大学医学院附属3201医院 (陕西 汉中 723000)

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摘要

目的分析多层螺旋CT对高危肺 癌人群的筛查价值及影像表现。方法 以 我院2012年1月-2014年6月行健康体检的 120例高危肺癌人群为研究对象,均行多 层螺旋CT检查,包括常规扫描、低剂量扫 描,观察并记录CT扫描对各肺叶结构、肺 部结节显示情况。结果 多层螺旋CT常规 剂量、低剂量扫描对各肺叶结构显示、肺 结节个数显示率比较差异无统计学意义(P >0.05)。多层螺旋CT检出肺部小结节33 个,其中良性28个,恶性1个,行手术治 疗,病理检查证实;需随访者3个,其中3 个月复查2个,显示结节增大,手术治疗 且经病理检查证实为早期肺癌,6个月复 查1个,结节大小变化不明显,18个月再 次复查结节中央呈现点样钙化,判定为良 性结节。结论 多层螺旋CT对各叶细节结 构、肺部结节数可清晰显示,对高危人群 肺癌早期筛查具有重要意义,且建议行低 剂量CT筛查。

Objective To analyze the value of multi-slice spiral CT in the screening of high-risk lung cancer and its imaging findings. Methods 120 patients with high-risk lung cancer who received health physical examination in our hospital from January 2012 to June 2014 were taken as the research objects. All the subjects underwent multislice spiral CT examination, including routine scan and low-dose scan. The lung lobe structure and pulmonary nodules displayed by CT scan were observed and recorded. Results The differences in displaying lung lobe structure and number of pulmonary nodules between routine dose and low-dose multislice spiral CT were not statistically significant (P>0.05). 33 small pulmonary nodules were detected by multi-slice spiral CT, including 28 benign and 1 malignant; Surgical therapy was performed and pathological examination was used to confirm. 3 patients needed to be followed up and 2 of them were reexamined in 3 months, showing enlargement of nodules. Through surgical treatment and pathological examination, they were confirmed as early lung cancer. 1 case was reexamined in 6 months. The size changes of the nodules were not obvious. 18 months later, the reeaxmination showed spot-like calcification in central nodules, determined as benign nodules. Conclusion Multi-slice spiral CT can clearly display the lobe structures and the number of pulmonary nodules, which is of great significance in the early screening of lung cancer in high risk population. Low-dose CT screening is suggested.

【关键词】多层螺旋CT;高危肺癌人群;筛查;影像表现

【中图分类号】R734.2

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.02.014

前言

据统计,我国恶性肿瘤病死患者中肺癌位居第三,且近年来其发 病率呈现不断上升趋势[1]。临床数据显示I期肺癌患者手术后5年生存 率高达60%~80%,而保守治疗5年生存率约10%[2]。为此加强肺癌早期 筛查至关重要,特别是吸烟相关高危人群。多层螺旋CT检查具有较高 时间分辨率、较高空间分辨率及后处理功能强大特点,对支气管狭 窄、各肺叶细微结构等均可清晰显示,且不同病理类型肺癌CT表现不 同[3],依据不同CT表现可准确判断早期肺部病变,提高肺癌早期筛查 检出率,便于早期治疗,改善其预后。基于此,本研究回顾性分析我 院2012年1月~2014年6月行健康体检120例高危肺癌人群多层螺旋CT影 像资料,探讨其对肺癌早期筛查作用,报告如下。