孤立性肺转移瘤的CT诊断

CT Diagnosis of Solitary Pulmonary Metastases

目的探讨孤立性肺转移瘤(SPM)的CT表现,以提高对SPM的CT诊断水平。方法回顾性分析23例经病理证实的SPM的CT表现。结果:①病灶分布:23例SPM中位于左肺13例,右肺10例;双肺上叶(不含左上叶舌段)3例,右中叶及左上叶舌段5例,双肺下叶12例;位于肺野外1/3者16例,中1/3者6例,内1/3者1例。②大小:<3 cm者18例,>3 cm者5例。③形态、边缘:16例呈圆形或椭圆形且表面光滑,界面清楚,7例呈不规则形并分别或同时见分叶征、毛刺征(2例)、胸膜凹陷征、血管集束征、晕环征(各1例)。④密度:病灶呈均匀软组织密度17例,内见钙化灶3例,空洞1例,低密度坏死区2例。⑤本组病例均未见SPM侵犯邻近支气管。结论SPM的CT表现具有一些特点,但其诊断与鉴别诊断需CT表现紧密结合临床和病理才能得出正确结论。

Objective To explore CT appearances to improve the level of CT diagnosis of SPM. Methods of solitary pulmonary metastases （SPM） in order The CT findings of 23 cases of SPM proved by pathology were analyzed retrospectively. Results 1. The distribution of lesions ： in 23 cases with SPM were ： 13 niduses in left lung, 10 in right lung; 3 in bilateral superior lobuses （excluding segmentum lingulare） , 5 in lobus medius and segmentum lingulare, 12 in inferior lobuses;16 in external 1/3 of lung field, 6 in middle 1/3 and 1 in interior1/3. 2. The diameter of lesions were： d 〈 3 cm （18）, d 〉 3 cm（5）. 3. The shape and the margin of lesions were： circular or ellipse niduses with smooth surface and clear tumor-lung interface in16,irregular-shaped niduses in 7, with lobulation sign in 2, spicular in 2 pleural indentation, bronchovascular bundles and halo in 1 respectively. 4. The density of lesions was： Uniform soft tissular density inl7 cases, calcification in 3, cavity in 1 and necrotic area in 2. 5. Among 23 cases, it was not found that SPM invaded bronchi nearby. Conclusion SPM has some characterizes on CT, but only by combining CT appearances with clinic and pathology, its correct diagnosis can be done.