纵隔型肺癌的X线及CT诊断

Pulmonary Cancer of Mediastinal Type:A Study of Imaging Manifestations

目的 提高对纵隔型肺癌影像学表现的认识。方法 常规 X线检查摄正侧位胸片。体层摄影检查 1 1例。CT检查采用 PICKER- 2 0 0 0 CT机 ,自肺尖至膈顶用层厚 ,层距均为 1 0 mm连续扫描。 CT增强检查 8例。结果 纵隔型肺癌的 X线表现 :癌肿阻塞较大支气管致肺叶不张紧贴于纵隔上 ,并包裹肺门肿块或纵隔肿块 ;隐匿性肺癌 ,X线平片仅可见纵隔增宽呈波浪状。纵隔型肺癌的 CT表现 :可清楚显示肿块的大小 ,形态 ,边缘。受累支气管的情况 ,肿块周围的情况。 CT可较早显示肺内转移病灶 ,骨骼破坏等。亦可较早显示肺内转移病灶 ,骨骼破坏等。对肿大淋巴结的显示 ,亦较 X线平片优越。结论 对纵隔型肺癌 ,X线平片 ,体层摄影 ,CT相结合 。

Objective To study the imaging features of pulmonary cancer of mediastinal type.Methods P A and lateral films, tomographs and CT scanning of the chest were performed in 16 cases of pulmonary cancer of mediastinal type, and the imaging features were analyzed.Results The manifestations on plain chest films were as follows: 1) the atelectatic lobe due to bronchial obstruction was found closely attached to the mediastinum, like a mediastinal mass; 2) peripheral lung cancer located just next to the mediastinum, seemed to be contiguous with each other; 3) few abnormalities could be seen in occult pulmonary cancers around the mediastinal region.CT could well show the size,shape and margin of the mass,the involvement of the bronchial lumen and also the pulmonary background around the lesion. CT could demonstrate the small pulmonary metastases,bone distruction,and lymph node enlargement in hilum and mediastinum earlier than plain film.Conclusion Diagnosis of pulmonary cancer of mediastinal type can be improved if chest plain films,tomographs and CT scannings of the chest are performed in combination.