3cm以下肺内球形病灶瘤-肺界面CT-病理对照(附50例分析)

CT-pathologic Correlation of Tumor-lung Interface in Pulmonary Global Lesions 3 cm or less (Analysis of 50 Cases)

本文复习了经手术病理证实的直径≤3cm的肺内球形病灶50例(肺癌37例、良性结节13例)的CT像。CT像显示结节边缘粗糙者小肺癌占81％、良性结节占31％。一个CT像层面上多毛刺(≥6个)结节小肺癌占73％、多毛刺(≥6个)者良性结节占15％。CT像见结节边缘有锯齿征8例,病理证实均为肺癌,此征与癌灶边缘不等速浸润生长有关。CT-病理对照结果显示锯齿征是诊断周围型小肺癌价值重要的一个CT征象。CT像上结节边缘的光滑程度及毛刺数的多少有助于周围肺球形小灶的良、恶性鉴别诊断。

We reviewed CT images of 50 pulmonary global lesions (37 lung cancers and 13 benign nodules) 3 cm or less proved pathologically in this paper. Ill-defined edge of the lung cancers were found in 30 (81％) and that of the benign nodules were in 4 (31％) on thin-section CT images. The number of the spiculations more than 6 of the lung cancers were found in 27 (73％) and that of the benign nodules were in 2 (15％) on a layer CT image. Serrated signs were only seen in 8 lung cancers because of the unequal speed development and infiltration of carcinoma tissue in the pathology. Comparison of CT images with pathologic data suggests that the serrated sign of nodule is a valuable sign in diagnosis of small peripheral lung cancer on CT image. The edge feat ure and number of spiculations of nodule are helpful to differential diagnosis between the malignancy and benignancy of small solitary lung nodules on CT images.