原发性气管肿瘤及肿瘤样病变的多层螺旋CT诊断研究(附29例分析)

Diagnosis of multi-detector spiral CT in primary tracheal tumors and tumor-like diseases:analysis of 29 cases

目的:探讨原发性气管肿瘤及肿瘤样变的MSCT特征及评价图像后处理技术的应用价值。方法:回顾性总结29例经病理证实的气管肿瘤及肿瘤样变的MSCT表现,并结合多种图像后处理技术,如多平面重建(MPR)、容积再现技术(VR)、CT仿真支气管镜(VB)图像进行分析诊断。结果:根据病灶的MSCT表现分为四种类型:①管腔内窄基底息肉样结节型;②管腔内广基底结节或肿块型;③单纯沿管壁浸润增厚型;④管腔内外肿块型。29例中,良性肿瘤4例CT表现为管腔内圆形或类圆形结节影,轮廓光滑,呈窄基底与管壁相连,局部管壁不增厚。低度恶性肿瘤17例表现为广基底结节或肿块或沿管壁浸润增厚为主。恶性肿瘤5例CT表现为管腔内外肿块,形态不规则,呈分叶状。此外2例炎性假瘤和1例气管硬结病患者亦具有良性病变的CT特征。结论:MSCT薄层横轴位及MPR、VR、VB图像重建技术能很好地显示气管病变的形态特征,定位准确,根据病变不同CT表现亦有助于定性诊断及肿瘤良恶性的鉴别,为临床治疗提供重要及可靠的影像学信息。MSCT是一种诊断准确性高,实用性较强的影像学检查方法。

Objective： To investigate characteristics of MSCT of the primary tracheal tumors and tumor-like diseases and evaluate application values of the image post-processing techilology. Methods： Retrospectively summarized MSCT findings in 29 cases with tracheal tumors and tumor-like diseases, which had been confirmed by patholoical examination, and combined with a variety of image post-processing technologies, such as muhiplanar reconstruction （MPR）, vohane reconstruction （VR）, virtual bronchoscopy （VB） image to analysis and diagnosis. Results： Four types were classified by the MSCT findings of tile lesions： （1）intraluminal polypoid nodules with narrow base; （2） intraluminal nodules or masses with wide base; （3） simplex infiltration and thickening along the wall; （4） intraluminal and extraluminal masses. Of the 29 cases including in tiffs study, 4 cases with benign tumors CT findings for intraluminal, round or similar round nodules, smooth contours, narrow base connected to the wall, not wall ttfickening; 17 cases with low-grade malignant tumors mainly showed wide bases nodules or masses or thickening and infiltration along the wall. 5 cases with malignant ttanors showed intraluminal and extraluminal masses, irregular shape, lobulated. The other 2 cases with inflammatory pseudotumor and 1 case with tracheal sclerosis showed CT features of the benign disease. Conclusion： Thin-section axial MSCT and MPR, VR, VB image reconstruction tectmiques can show morphological characteristics and accurate position of tracheal lesions better. According to CT features of different diseases, it also contributes to the qualitative diagnosis and the identification of benign and malignant tunlors, and provides important and reliable imaging information for clinical treatment. MSCT is a high diagnostic accuracy, more practical imaging method.