螺旋CT三维重建及多平面重建研究孤立性肺结节与胸膜的关系

Study on the relationship between SPN and Pleural with 3D and multiplanar reconstruction of CT

目的研究肺野孤立性肺结节(SPN)与胸膜的关系,进一步探讨其对孤立性肺结节的诊断价值。方法选56例患孤立性肺结节的患者(病灶位于肺野外围,距脏层胸膜小于2-5 cm范围),对其病灶进行螺旋CT高分辨扫描,后于SUN工作站进行三维重建及多平面重建;将本组病例进行针吸活检或手术或随访证实其病理结果,将以上结果加以对照,研究SPN与胸膜的关系。结果 56例SPN患者,与胸膜有直接关系者43例,占77％,当病灶距胸膜小于2．5 cm时,才有可能出现胸膜凹陷征,当SPN距胸膜>1．0 cm时,炎性假瘤发生胸膜凹陷征的机率很低,当SPN距胸膜<1．0 cm时,肺癌、结核球、炎性假瘤均可发生胸膜凹陷征,而凹陷胸膜的深度:结核球、肺癌>炎性假瘤,胸膜牵拉线的数量与病灶的形态、大小及位置关系密切。结论胸膜凹陷征的发生与SPN距胸膜距离关系密切,而SPN的性质与胸膜牵拉线及牵拉胸膜存在相关性。

Objective To investigate the relationship between SPN and Pleural and further to assess the diagnostic value in SPN. Methods 56 cases of SPN（lesions locate periphery of lung,within 2.5cm along pleural） were examined with high resolution CT and followed 3D and multiplanar reconstruction in SUN workstation. All cases were performed aspiration biopsy,operation or follow-up to get the pathological result,and the results were analyzed and compared to investigate the relation of Pleural and SPN. Results 43 of 56（77 % ） were directly relative to pleural. When the distance between lesion and SPN was less than 2.5cm,it was possible to see pleural indentation. When the distance was longer than 1.0cm,there was little chance for inflammatory pseudotumor to see pleural indentation. When the distance was less than 1.0cm, lung cancer, tuberculoma, inflammatory pseudotumor could all have pleural indentation. The depth of pleural indentation： tuberculoma 〉 lung cancer 〉 inflammatory pseudorumor. Conclusions The number of pleural is closely relative to the shape size and position. The occurrence rate of pleural indentation is closely relative to the distance between SPN and pleural,and the nature of SPN has correlation with pulling pleural.