X线、CT诊断肺癌性淋巴管炎的应用价值研究

Evaluation of x-ray and CT diagnosis of pulmonary lymphangitic carcinomatosis

目的探讨肺癌性淋巴管炎的X线、CT表现及其临床应用价值。方法回顾性分析40例经支气管镜活检、胸膜活检或开胸肺活检证实的肺癌性淋巴管炎的X线、CT及HRCT征象,评价其影像学诊断的临床应用价值。结果肺癌性淋巴管炎主要表现为支气管血管束串珠状增粗、小叶内细网结节状影、小叶间隔小串珠状增厚、小叶核心结节、胸膜结节、肺门和/或纵隔淋巴结增大、胸腔积液及双肺弥漫分布的小空泡样阴影。结论肺癌性淋巴管炎的影像学表现具有一定特征,其影像诊断以HRCT为最佳,但优质的胸部X线平片和CT平扫可以提供一些有益征象。

Objective To study the x-ray and CT findings of pulmonary lymphangitic carcinomatosis（PLC）,and to discuss it’s clinical value.Methods The imaging materials of 40 cases’ PLC which were proved by bronchoscopic or pleural or open-lung biopsy were retrospectively analyzed,and the clinical application of imaging diagnosis were investigated.Results The major features of PLC included： beaded thickened bronchovascular bundles,intralobular small reticular and nodular shadows,small beaded thickened interlobular septums,lobular core nodes,pleural nodes,tumescent pulmonary hilar and/or mediastinal lymph nodes,hydrothoraxes,small vacuolar opacities diffusely distributed over the bilateral lung.Conclusions PLC possess relative imaging feature,particularly HRCT is the most satisfactory method in diagnosing PLC,but the super-quality thoracic plane film and CT traditional scan can supply some useful signs of PLC.