肺炎型细支气管肺泡癌的螺旋CT诊断

SPIRAL CT DIAGNOSIS FOR PNEUMONIA-TYPE BRONCHIOALVEOLAR CARCINOMA

目的探讨肺炎型细支气管肺泡癌(PBAC)的螺旋CT表现及鉴别诊断要点。方法回顾性分析22例经病理证实并有完整病史资料的PBAC的螺旋CT表现。结果累及1个肺叶3例,多个肺叶19例,片状阴影22例,蜂窝征22例,枯树枝征15例,CT血管造影征3例,片状磨玻璃影3例,叶间裂膨隆、牵拉、僵硬18例,邻近纵隔胸膜面的"线样征"13例,病灶周边及远处多发结节影9例,结节内伴空泡征7例,少量胸水5例,纵隔淋巴结大2例。本组病例中15例有CT复查资料,显示病灶范围扩大、密度变实。结论通过对PBAC的螺旋CT表现的正确分析,有助于临床上及时做出准确诊断。

Objective To study the CT features of pneumonic bronchioalveolar carcinoma（PBAC） and it＇s differential diagnosis. Methods The CT features of 22 cases of PBAC with intact clinical information and pathologic results were retrospectively analyzed. Results The main CT findings were： one lobe and multiple lobes involved were three and 19 cases,respectively;lamellar shadow（22 cases）,honeycomb sign（22）,dead-tree-branch sign（15）,angiogram sign（3）,lamellar crude glass opacity（3）,bulging,drag,and stiffness of interlobar fissure（18）,string sign nearby mediastinal pleura（13）,multiple nodulesaround the lesions and in distant part（9）,in which,seven with vacuole sign;little pleural fluid（5）,and enlarged mediastinal lymph node（2）.Of the 22 cases reviewed,15 underwent CT recheck showed that the lesions were expanded,and the density became solid. Conclusion A correct analysis of the CT features of PBAC is conducive to making a timely and accurate diagnosis of the condition.