CT扫描对诊断肺癌肺内转移的临床意义

Clinical significance of CT scans in the diagnosis of intrapulmonary metastases from lung cancer

目的研究肺癌的肺内转移途径及其CT表现。方法 34例经病理或临床证实的肺癌肺内转移患者均接受了胸部常规CT扫描,随后,对所有患者的CT表现进行了回顾性分析。结果在34例肺癌肺内转移患者中,血道转移见于18例,CT表现为肺内结节或肿块影;淋巴道转移4例,CT表现为支气管血管束及小叶间隔的不规则形或结节状增厚;支气管播散5例,CT表现为沿支气管分布的结节状或不定形实变影;混合性转移7例,包括4例血道转移伴淋巴道转移,2例支气管播散伴淋巴道转移以及1例血道转移伴支气管播散,CT表现为多种病灶混合存在。结论 CT扫描能鉴别肺内转移瘤与原发肺癌,并能判定其转移途径,因此,它有助于尽早作出明确诊断。

Objective To study the metastatic paths and CT findings of intrapulmonary metastases（IPM） from lung cancer（LC）.Methods Thirty-four patients with pathologically or clinically proved IPM from LC underwent conventional CT scans of the chest.Subsequently,CT findings of all patients were analyzed retrospectively.Results Among 34 patients with IPM from LC,hematogenous metastases were found in 18 cases whose CT images showed intrapulmonary nodules or masses;lymphatic metastases in 4 cases whose images showed irregular or nodular thickening of bronchovascular bundles and interlobular septa;bronchial spread in 5 cases whose CT images showed nodular or amorphous air-space consolidations distributed along the bronchi;mixed metastases in 7 cases who comprised 4 hematogenous metastases associated with lymphatic metastases,2 bronchial spread with lymphatic metastases,and 1 hematogenous metastasis with bronchial spread,whose CT images showed the coexistence of multiform foci.Conclusion CT scans could differentiate the intrapulmonary metastases from primary lung cancers and could identify their metastatic paths,and thus it is helpful to make a definite diagnosis as soon as possible.