周围型肺癌的CT诊断价值

Evaluation of CT in Diagnosis of Peripheral Pulmonary Carcinoma

目的：研究ＣＴ在周围型肺癌诊断中的价值。材料与方法：对６３例经手术和／或病理证实的周围型肺癌行常规肺部ＣＴ扫描，并在病灶处用薄层高分辨力重建方式加扫。结果：周围型肺癌表现为肺内肿块或结节，形状为椭圆形或不规则形。其中４７例肿块直径≥３ｃｍ，其密度不均，少数肿瘤内可见钙化、坏死、液化和空洞。１６例肿瘤直径＜３ｃｍ，其密度不均，呈分叶状，薄层扫描时可见空泡征。肿瘤病灶边缘可见毛刺、棘突、支气管血管纠集、胸膜粘连和胸膜凹陷征等。胸膜粘连多见于肿块较大的肺癌，胸膜凹陷征多见于肿块较小的肺癌。结论：ＣＴ诊断周围型肺癌比常规Ｘ线检查提供更多的信息；若ＣＴ发现肺部周围结节或肿块有分叶、毛刺及胸膜凹陷征等应考虑为肺癌，肺门、隆突下及纵隔淋巴结肿大且无钙化时，要考虑肺癌向淋巴结转移。

Purpose:To evaluate the diagnostic value of CT in patients with peripheral lung carcinoma.Materials and Methods:Routine CT scanning was performed in 63 cases of peripheral lung carcinoma confirmed by surgery and/or pathology,if a lesion was found in CT scanning,thin slice scanning of the lesion wth high resolution reconstruction was done.Results:The peripheral pulmonary carcinoma showed a mass or nodule of lungs in CT sanning,its shape was elliptical or irregular.The density of mass whose diameter is bigger than or as big as 3cm is equal,calcification,necrosis,liquefaction and vacity can be found in some cases.The density of mass whose diameter is less than 3cm is unequal,the mass is lobulous;The thin slice of high resolution CT scanning may find vacuole.Spicules,protrusion,bronchovascular convergence,pleural adhesion and pleural indentation also can be found in brim of mass.Conclusion:CT scanning can provide more information about peripheral pulmonary carcinoma than routine X ray.The lobulation,spicules and pleural indentation around the mass suggest the diagnosis of pulmonary carcinoma.