磨玻璃样孤立结节型细支气管肺泡癌的CT诊断

Ground glass appearance of solitary nodules of bronchioloalveolar carcinoma CT diagnosis

【摘要】目的探讨磨玻璃样孤立结节型细支气管肺泡癌的cT影像学特点。方法回顾性分析经病理证实的20例以磨玻璃样孤立结节型细支气管肺泡癌的cT影像学及临床资料。结果20例孤立结节型细支气管肺泡癌多无明显临床症状；部位：左肺上叶10例，右肺上叶5例，右肺中叶3例，左肺下叶2例；所有病灶均位于肺外周部，均见磨玻璃样结节影，其中14例病灶周边见毛刺征，5例有空泡征，8例有支气管充气征，16例有胸膜凹陷征，10例有血管集束征等。加例病灶增强扫描后病灶无明显强化。所有病例通过cT动态随访观察，病灶大小无明显变化，病灶密度略增高，最终进行肺叶切除经病理诊断为非黏液型肺泡细胞癌。结论磨玻璃样孤立结节型细支气管肺泡癌进展缓慢，影像学动态观察有助于明确诊断。

Objective To investigate the ground glass appearance of solitary nodules of bronchioloalveolar carcinoma of the CT imaging features. Methods A retrospective analysis of 20 cases with pathologically proved with a ground glass appearance of solitary nodules of bronchioloalveolar carcinoma of the clinical and imaging data of CT. Results 20 cases of solitary nodules of bronchioloalveolar carcinoma without obvious clinical symptoms ;location：the upper lobe of the left lung in 10 cases, right upper lobectomy in 5 cases,3 cases of the right middle lobe,lower lobe of the left lung in 2 cases;all lesions were located at the lung periphery,both ground glass opacity nodules, 14 of them patients with lesions of the peripheral see spiculation in 5 cases, vacuole sign,8 cases with air bronchogram, 16 cases with pleural indentation, 10 cases of vascular convergence sign etc.. In 20 cases the lesion enhancement scan after the lesion showed no enhancement. In all cases, through the GT dynamic observation, no obvious change in lesion size,le- sion slightly higher density, finally performed lobectomy pathologically diagnosed non mucoid alveolar cell carcinoma. Conclusion the ground glass appearance of solitary nodules of bronchioloalveolar carcinoma progress is slow, dynam- ic imaging observation helps to confirm the diagnosis.