肺癌性淋巴管播散的CT表现

CT Manifestations in Pulmonary Lymphangitic Spreading

分析肺癌性淋巴管播散的CT表现，讨论诊断与鉴别诊断以及CT检查对本病的诊断价值。材料和方法：分析问例肺癌性淋巴管播散的有关资料，原发灶12例是肺癌，正例原发灶不明。且11例有常规CT扫描，其中8例加作高分辨率CT（HRCT）扫描：另2例单作HRCT检查。结果：10例有支气管血管束增厚，大部分呈边缘不规则状。9例显现多为均匀的小叶间隔增厚。胸膜病变有叶间胸膜增厚（8例）、胸膜结节（3例）、胸水（4例）。心包积液4例。9例有胸内淋巴结肿大，其中7例累及肺门淋巴结。结论：常规CT加HRCT能清晰显示肺癌性淋巴管播散的影像学表现而有利于正确诊断。考虑到的鉴别诊断有胸部结节病、间质性肺水肿。

To analyse the CT findings of pulmonary lymphangitic spreading and discuss the value of CT imaging in diagnosing the disease. Materials and Methods: 13 cases were collected. The primary lesions in 12 of these 13 patients were bronchogenic carcinoma(n=12), the primary lesion of the other case was unknown. 11 cases had CT scans with 10mm slice thickmess, including 8 with additional High Resolution CT(HRCT), the other 2 cases had HRCT only. Results: Thickening of bronch-vascular bundles in 10cases, with majority of uneven thickenings. Smooth thickening of interlobular sepia were seen in 9 cases. Pleural changes were consisted of interlobar pleural thickening(n=8), nodules(n=3) and pleural effusion(n=4). Pericardical effusion appeared in 4 cases. Lymphadenopathy appeared in 9 cases were hilar nodes involvement in 7 cases. Conclusion: Conventional CT with the help of HRCT can show the manifestations of lymphangitic spreading clearly useful for accurate diagnosis. Differential diagnostic considerations include thoracic sarcoidosis, interstitial edema of lung.