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64例周围型肺癌的CT影像表现特点分析*

作者:徐 锋 张祎捷 韩纪昌 张雅军

所属单位:河南大学淮河医院呼吸科(河南 开封 475000)

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摘要

目的分析64例周围型肺癌 的 电 子 计 算 机 断 层 扫 描 ( C o m p u t e d Tomography,CT)影像表现特点。方法 选取我院64例经术后病理学检查确诊为 周围型肺癌患者纳入研究,对其临床诊 治资料进行回顾性分析,并总结CT影像 表现特点。结果 43例(67.19%)右肺(包 括29例上叶、5例中叶、9例下叶),21 例(32.81%)左肺(包括10例上叶,7例中 叶、4例下叶);病灶大小(6.52±0.68) cm×(3.17±0.34)cm;形态特征:23例 (35.94%)不规则斑片阴影,41例(64.06%) 圆形、类圆形阴影;边缘分型:6例 (9.37%)边缘光滑整齐,58例(90.63%)为 不光滑平整清晰,其中不光滑平整清晰 包括21例毛刺征、27例分叶征与10例小 泡征;密度分型:26例(40.62%)实质高 密度影,27例(42.19%)低密度影,11例 (17.19%)密度不均匀;25例(39.06%)磨 砂玻璃样结节,12例(18.75%)蜂房样结 节,18例(28.13%)空泡征样结节,9例 (14.06%)软组织密度结节;病灶和邻近组 织关系分型:36例(56.25%)为凹陷征,28 例(43.75%)为血管集束征。结论 了解周 围型肺癌CT影像表现特点,进行图像资料 分析,可为早期准确诊断提供重要依据, 使患者得到及时治疗,对延长其生存期具 有积极意义。

Objective To analyze the computed tomography (CT) imaging findings of 64 cases of peripheral lung cancer. Methods 64 patients with peripheral lung cancer diagnosed by postoperative pathological examination were enrolled in the study. The data of clinical diagnosis and treatment were analyzed retrospectively, and CT imaging findings were summarized. Results Lesions were distributed in right lungs (superior lobes of 29 cases, middle lobes of 5 cases, inferior lobes of 9 cases) of 43 cases (67.19%) and left lungs (superior lobes of 10 cases, middle lobes of 7 cases, inferior lobes of 4 cases) of 21 cases (32.81%). The size of the lesion was (6.52±0.68)cm×(3.17±0.34)cm. Morphological characteristics included irregular patchy shadow in 23 cases (35.94%) and round and quasi-circular shadow in 41 cases (64.06%). Marginal classification showed that the margin was smooth and tidy in 6 cases (9.37%) and not smooth, tidy or clear in 58 cases (90.63%) (21 cases of spicule signs, 27 cases of lobulation signs, 10 cases of bubble signs). Density classification included parenchyma high density shadow in 26 cases (40.62%), low density shadow in 27 case (42.19%) and inhomogeneous density in 11 cases (17.19%). There were 25 cases (39.06%) of ground glass like nodules, 12 cases (18.75%) of honeycomb like nodules, 18 cases (28.13%) of vacuolar sign like nodules and 9 cases (14.06%) of soft tissue density nodules. The classification of relationship between the lesion and adjacent tissues showed sulcus signs in 36 cases (56.25%) and vessel convergence signs in 28 cases (43.75%). Conclusion Understanding CT imaging findings of peripheral lung cancer and analyzing the image data can provide an important basis for early diagnosis and timely treatment of patients, which is of positive significance for prolonging the survival time.

【关键词】周围型肺癌;电子计算机断层扫描;影像;表现特点

【中图分类号】R734.2

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2018.07.003

前言

肺癌可对人类健康造成严重危害,有调查表明,男性群体中肺 癌发病率占首位,且其在女性群体中也呈现出不断上涨趋势,不仅 影响患者正常生活,而且增加了经济负担。对肺癌给予早期诊断, 可延长患者生存期,因而早发现早诊治具有重要意义[1-2]。早期诊 断过程中,辅助检查手段发挥着巨大作用。在当前医学影像技术日 益发展的背景下,肺癌诊断常用辅助检查方法为X线、磁共振成像 (Magnetic Resonance Imaging,MRI)、电子计算机断层扫描(Computed Tomography,CT)等。X线误诊率相对较高;MRI特异性较低,且价格昂 贵;CT在肺癌诊断以及分期上具有较高价值,属于无创检查,故较常 用于肺癌诊断[3-4]。本文以64例周围型肺癌作为研究对象,分析其CT影 像表现特点。