孤立性肺结节的影像学分析

Imaging analysis of solitary pulmonary nodules

目的探索孤立性肺结节的影像学征象,提高对本病的认识。方法回顾性分析经临床和病理证实的40例孤立性肺结节的影像(X线,CT)表现。结果40例孤立性肺结节包括23例周围型肺癌,10例结核球,4例球形肺炎,以及3例错构瘤。周围型肺癌23例,主要影像学表现:18例有分叶征,14例有毛刺征,13例有胸膜凹陷征,12例有血管集束征,4例有空气支气管征和空泡征;结核球10例,7例结节内有钙化,3例有卫星灶;球形肺炎4例,均表现为结节靠近胸膜生长呈中心密度高而周围密度较淡阴影;错构瘤3例,1例内部有脂肪密度,1例内部见爆米花样钙化。结论正确认识孤立性肺结节的形态学特征、内部结构及合理运用相关的影像学检查方法能提高此类疾病的正确诊断率。

Objective To investigate the imaging findings of solitary pulmonary, nodules（SPN）so as to elevate the recognition of this disease. Methods The imaging（X -ray and CT） findings of 40 patients with clinically and pathologically proved SPN were analyzed retro- spectively. Results Forty patients with SPN comprised 23 peripheral lung cancer, 10 tuberculous ball, 4 spherical pneumonia and 3 hamartom. On images of 23 peripheral lung cancer, the lesions presented lobulated sign（18）, spiculated sign（14）, pleural indentation（13）, vessel convergence （12）, and air bronchogram and vacuole sign （4）. On images of 10 tuberculos ball, the lesions presented intranodular calcification （7） and satellite -like lesions（3） . On images of 4 spherical pneumonia, all lesions were grown near the pleura and the central density was higher than that of peripheral area. On images of 3 hamartoma, the lesions presented intratumoral fatty density（1） and intratumoral explosive rice -form calcification （1）. Conclusion If only fully understand the morphologic features and inside structures of SPN, the diagnostic level will be can elevated.