高分辨率CT对肺内癌性淋巴管炎的诊断价值

Usefulness of high resolution CT in the diagnosis of pulmonary carcinomatous lymphangitis

目的探讨肺内癌性淋巴管炎(PCL)的高分辨率CT(HRCT)表现,并评价其对诊断与鉴别诊断的临床意义。方法54例经临床与病理证实的PCL患者均经HRCT检查,对所有患者的HRCT表现进行了回顾性分析。结果在本组患者中,HRCT扫描或多或少显示了下列征象:向心性分布多边形结构(83%),"U"或"Y"型的线样致密影(55%),支气管血管束增粗(88%),叶间裂结节样增厚(59%),磨玻璃样致密影(59%),周围型线样影(11%),小结节影(27%),肺门或纵隔淋巴结肿大(72%),胸腔积液或合并心包积液(64%)以及胸膜结节(40%)。结论HRCT有助于PCL的诊断及其与肺部其他弥漫性浸润性病变的鉴别。

Objective To explore HRCT findings of puhnonary carcinomatous lymphangitis （PCL） and to evaluate their clinical significance for the diagnosis and differential diagnosis.Methods Fifty-four patients with clinically and pathologically proved PCL underwent HRCT examinations and then the HRCT findings in all patients were analyzed retrospectively.Results In the group patients,HRCT scans showed more or less following signs：centripetally distributed polygonal structures （83%）,＂V＂or＂Y＂word linear dense shadows （55%）, broncho-vascular bundle thickening（88%）,nodular thickening of fissures interlobaris（59%）,ground-glass dense shadows（59%）,peripheral- type linear shadows（11%）,small-nodular shadows （27%）,pulmonary portal or mediastinal lymphonode enlargement（72%）,hydrothorax or pericardiac effusion （64%）and pleural node shadows （40%）.Conclusion HRCT is helpful to diagnose PCL and to differentiate PCL from other pulmonary diffuse or infiltrating lesions.