2cm以下周围型小肺癌的CT诊断(附32例分析)

CT diagnosis of small peripheral lung cancer less than 2 cm in diameter:an analysis of 32 cases

目的进一步提高对周围型小肺癌(SPLC)及早期肺癌的CT诊断水平。方法收集经手术或穿刺病理证实直径小于等于2cmSPLC29例,经临床证实3例。全部病例先行常规扫描,病灶区再行薄层或高分辨率CT扫描,21例做了增强扫描,增强扫描前先平扫。结果32例CT均表现为单发结节,其中,实性软组织密度结节23例,中心实性周边磨玻璃密度结节5例,不均匀较低密度结节4例。病灶具有毛刺征25例,分叶征21例,胸膜凹陷征10例,血管集束征8例,棘状突起征6例,小泡征5例,支气管气相征3例,脐凹征3例,小结节堆砌征1例,高密度点条征1例。结论CT,特别是HRCT对SPLC及早期肺癌具有重要的诊断价值,征象出现越多肺癌的可能性越大;合理的窗技术对SPLC征象的显示有重要帮助。

Objective To evaluate the value of CT scanning in the diagnosis of small peripheral lung cancer （SPLC） less than 2 cm in diameter and early lung cancer. Methods Thirty - two patients with SPLC in which 29 cases were confirmed by surgery or percutaneous needle biopsy and 3 cases were confirmed by clinical follow - up underwent routine CT scans included thin slice or HRCP scans. Twenty - one patients underwent additional enhanced scans after CT plain scans. Results The lesions of SPLC in all patients presented as single nodules, of them, the nodules with solid soft tissue density were found in 23 cases, solid center and ground glass density border in 5, and heterogeneous low - density in 4. The spiculated sign of the lesions was found in 25 cases, lobulated sign in 21, pleural indentation sign in 10, angiogram sign in 8, acanthoid processus sign in 6, small vesicle sign in 5, air bronchogram sign in 3, unbilicated sign in 3, nodular stack sign in 1, and high density strip sign in 1. Conclusion CT, especially HRCT has important value for diagnosing SPLC while the more CT signs are the more possibility of SPLC. The reasonable application of window technique is very helpful to reveal CT signs of SPLC.