论著-头颈部
肺部转移瘤的发生 情况及多层螺旋CT 诊断价值
作者:金 冰1 樊新柯1 杨 磊2 林 涛1 胡述提1
所属单位:1.河南省南阳市中心医院胸外科 (河南 南阳 473009) 2.河南省南阳市中心医院CT影像科 (河南 南阳 473009)
PDF摘要
目的 分析肺部转移瘤的发生情 况及多层螺旋CT(MSCT)诊断价值。方法 选取2015年7月至2017年8月我院行MSCT检 查的62例肺部转移瘤病变患者为研究对 象,分析其原发灶类型、转移类型及MSCT 中病灶边缘、形态、内部结构等影像特 征,并以病理结果为金标准,评估MSCT 的诊断效能。结果 62例患者经病理证实 肺部转移瘤60例,良性病变2例,原发灶 类型:消化系统31例(51.67%)、呼吸系 统恶性肿瘤13例(21.66%)、乳腺恶性肿 瘤10例(16.67%)、其他6例(10.00%),转 移类型:弥漫转移型20例(33.33%)、多 发转移型33例(55.00%)、单发转移型7例 (11.67%);MSCT检查中,出现分叶征25例 (40.32%)、毛刺征13例(20.97%)、晕征2 例(3.23%)、钙化4例(6.45%)、支气管征 象6例(9.68%);MSCT增强扫描诊断肺部转 移瘤的灵敏度、准确度均明显高于MSCT平 扫(P<0.05),而特异度比较差异无统计 学意义(P>0.05)。结论 肺部转移瘤主要 发生在消化系统、呼吸系统等恶性肿瘤 中,且以多发转移较常见,采用MSCT检查 有一定影像特征,尤其是MSCT增强扫描具 有较高诊断效能,值得在临床推广应用。
Objective To analyze the occurrence of pulmonary metastases and the diagnostic value of multislice spiral CT (MSCT). Methods A total of 62 patients with pulmonary metastases which examined by MSCT during the period from July 2015 to August 2017 were selected as the subjects. The types of primary lesions, types of metastases and MSCT image features, such as the edge, shape and internal structure of lesions were analyzed. The diagnostic efficiency of MSCT was evaluated with pathological findings as the golden standard. Results Among the 62 patients, 60 cases with lung metastases and 2 cases with benign lesions were confirmed by pathology. The types of primary tumors were digestive system in 31 cases (51.67%), respiratory system malignant tumors in 13 cases, malignant breast tumors in 10 cases (16.67%) and the other 6 cases (10.00%). Types of metastases included diffuse metastases in 20 cases (33.33%), multiple metastases in 33 cases (55.00%) and single metastasis in 7 cases (11.67%). MSCT examination showed that there were lobulated signs in 25 cases (40.32%), spicule signs in 13 cases (20.97%), halo signs in 2 cases (3.23%), calcification in 4 cases (6.45%) and bronchial signs in 6 cases (9.68%).The sensitivity and accuracy of MSCT enhanced scan in diagnosing pulmonary metastases were significantly higher than those of MSCT plain scan (P<0.05), but there was no statistically significant difference of specificity (P>0.05). Conclusion Pulmonary metastases mainly occur in digestive system, respiratory system and other malignant tumors, and multiple metastases are more common. Image features of MSCT scan are characteristic, and the diagnostic efficiency of MSCT enhanced scan is high.
【关键词】转移瘤;多层螺旋CT;诊断价值
【中图分类号】R734.2;R814.42
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2018.05.018
前言
除肺癌手术外,转移瘤切除术为胸外科开展较多的手术,大部分 肺部转移瘤患者无特异性症状,待转移瘤侵犯胸壁引起胸痛,癌灶大 量坏死引起反复咯血,最终为减轻症状而选择手术切除,故转移瘤的 早期诊断有重要意义[1-2]。肺部转移瘤的诊断主要依赖于影像学检查, 临床多运用胸部X线或胸部CT平扫结合肺功能检查进行诊断,随影像 技术及计算机软件技术快速发展,多层螺旋CT(Multislice spiral computerized tomography,MSCT)在肺癌诊断中广泛运用,但肺部转移 瘤的MSCT与原发灶之前的关系较少报道[3-4]。本文主要分析我院胸外科 肺部转移瘤发生情况、原发灶情况及MSCT对其诊断价值,结果如下。
中国CT和MRI杂志
第16卷, 第 5 期
2018年05月
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