周围型小肺癌的CT诊断与临床病理分型

CT Diagnosis of Peripheral Small Lung Cancer and Clinical Pathologic Typing

目的评价周围型小肺癌的CT影像特征对临床组织病理分型的诊断价值。方法回顾分析我院1998～2010年经手术、支气管镜检及痰检等病理证实的80例周围型小肺癌的CT表现,对其中30例周围型小肺癌进行多平面重建(MPR),并与横断薄层扫描对比分析,统计CT边缘有毛刺征的例数。结果短细毛刺多见于周围型肺癌的组织学类型-腺癌,毛刺以背离肺门方向分布为特点。MPR显示病灶内的微小钙化及小空泡征明显高于薄层扫描。结论多层螺旋薄层扫描及MPR图像可清楚地显示肺内小病灶影象特征,对周围型肺癌的诊断及鉴别诊断具有较高价值,为临床病理分型提供了重要依据。

Objective To explore tbe diagnostic value of CT imaging to peripheral small lung cancer and its clinical pathologic typing. Methods The retrospective analysis was made on the CT features of 80 cases from 1998 to 2010. They had been identified as small peripheral lung cancer by operation, bronchoscopy and smear pathologicat specimen. According to the CT features of 30 cases out of them, multiplanar reconstruction （MPR） had been made and compared with transverse thin-layer scanning to find case who had CT edge burr fea- ture. Re.suits Fine short burrs had been shown more in peripheral lung cancer which was adenoearcinoma. Burrs was characterized by departing feature from hilus of lung. MPR showed more micro-calcification and small vacuole sign than thin-layer scanning. Conclusion Multislice spiral thin-layer CT scanning and MPR images can clearly display small lesions of lungs. They have higher value in diagnosis and differential diagnosis of pe- ripheral lung cancer and providing clinical pathologic typing with important reperences.