纵隔型肺癌的影像学表现及诊断体会

The imaging features and diagnosis of pulmonary cancinoma of mediastinal type

目的探讨纵隔型肺癌的影像学表现,为诊断与鉴别诊断提供依据。方法回顾性分析11例经手术、病理和细胞学证实的纵隔型肺癌的X线和CT资料。结果11例病人中有4例肿瘤位于左肺门,3例位于右肺门,右上肺和左上肺各2例。平片显示纵隔增宽,气管受压移位,2例可见胸腔积液。CT显示肿块位于纵隔胸膜下,与纵隔分界清楚或呈宽基底相贴,边缘不规则,显示分叶征、毛刺征、血管纠集征、纵隔淋巴结肿大,增强后不均匀强化。结论结合临床症状、体征,影像学表现,大部分纵隔型肺癌都可以作出准确诊断。

Objective： To explore the clinical features and image presentations of pulmonary cancer of mediastinal type for more accurate diagnosis. Methods The clinical, X-ray and CT data of 11 patients with pulmonary cancer of mediastinal type were analyzed retrospectively. All patients underwent anteroposterior and lateral position X-ray film examination and CT scans and 7 of them underwent contrast-enhanced CT scans. Results Of all 11 patients, 4 of the tumors were located in the left hilum, 3 in the right hilum, 2 in the right upper lung and 2 in the left upper lung respectively. All of the tumors demonstrated wider mediastinal and the trachea was pushed, 2 cases were accompanied with pleural effusion. On CT films, tumors were located to the subpleura of mediastinal with wide base and irregular margin. All of the tumors demonstrated sublobe, sentus, blood vessel muster and lymphadenectasis of mediastinal lymph node. After administration of contrast media, all of the tumors were enhanced unequally. Condusions Conbined with clinical symptoms and signs, the majority of pulmonary cancer of mediastinal type can be diagnosed accurately after careful analysis of imaging features.