周围型小肺癌的CT诊断

CT diagnosis of primarg small peripheral lung cancer

目的:探讨胸部CT平扫和动态增强在诊断原发周围型小肺癌的临床价值。方法:回顾性分析10年来经手术和穿刺活检等病理证实,有完整资料的46例原发周围型小肺癌。所有患者通过传统X线筛选后做常规CT平扫(层厚层距10mm),同时在病灶区薄层扫描(层厚、层距2mm)及动态增强并分析影像特征。结果:46例中25例有分叶征,36例有毛刺征,12例有空泡征,13例有血管纠集征,18例有胸膜凹陷征。病变均位于肺外围。46例均行过增强扫描,病灶呈中度增强,CT值增幅为20～70HU。结论:采用CT薄层扫描及动态增强,结合CT导向下穿刺活检,对原发周围型肺癌定性诊断十分重要,为选择治疗方法和预后提供有意义的指导价值,有利于提高患者的存活率和生存质量。

Objective：To explore the clinical value of conventional thoracic CT scanning and dynamic enhanced CT scanning in the diagnosis of primarysmall peripheral lung cancer.Methods：The retrospective analysis in 46 cases of primary small peripheral lung cancer with complete data during last ten tears,which were pathologically confmned by operation and biopsy was performed.All patients were screened by convention X-ray,then the conventional plain CT scanning （with 10 mm collimation thickness）,thin slice scanning of the focus zone （with 2 mm collimation thickness） and dynamic enhanced CT scanning were performed respectively.The image features were analysed carefully.Results：Of 46 patients with lung cancer,lobulation sign was seen in 25 cases, spiculation sign in 36,vacuolated sign in 12,convergence of peripheral vessels in 13 and pleural indentation in 18.All the foregoing pathological changes were located in the periphery of lung.Enhanced scanning in all cases showed that the loci were moderately enhanced and the amplitude of CT value was 20-70 HU.Conclusion：It is of great importance for the qualitative diaqnosis of primary small peripheral lung cancer to use the thoracic CT scanning and dynamic enhanced CT scanning,and combine with needle biopsy conducted by CT.It is also helpful to select the therapeutic methods,estimate the prognosis and improve the survival rate of these patients and quality of life.