肺癌性淋巴管炎CT表现的特征性分析

The Analysis of CT Characteristic of Pulmonary Lymphangitic Carcinomatosis

目的探讨肺癌性淋巴管炎的特征性CT表现。方法回顾性分析临床已确诊的51例肺癌性淋巴管炎,各例病例均曾采用16排或64排螺旋CT进行平扫,对原始数据进行软组织算法、骨算法及多模式重建成像,对所得CT图像进行分析及总结。结果 51例均可见不同程度肺纹理不规则增多、增粗、模糊,其中43例增粗肺纹理可见多发微小结节;小叶间隔不规则增厚36例,其中28例小叶间隔可见微小结节;肺小叶内间质增生及(或)核心小结节及12例;胸膜不规则轻度增厚及多发微小结节32例;肺门和(或)纵隔淋巴结肿大31例;肺内结节及或小斑片状实变影25例;胸腔液29例;心包轻度增厚和(或)少量积液12例。结论肺纹理不规则增粗并多发微小结节、肺小叶间隔不规则增厚并多发微小结节及胸膜轻度增厚并多发微小结节这三种CT表现具有一定特征性,螺旋CT是诊断肺癌性淋巴管炎的有效手段。

Objective To investigate the characteristic CT findings of pulmonary lymphangitic carcinomatosis. Methods Retrospective analyzed the CT data of 51 cases of pulmonary lymphangitic carcinomatosis. The original data were used for the reconstruction of soft tissue algorithms, bone reconstruction algorithms and multi-mode. And the results were analyzed and summarized. Results 51 cases have the performance of varies degrees of irregular markings increased thickening, fuzzy, where 43 cases of enlargement markings shows multiple small nodules; 36 cases of septal irregular thickening, which 28 cases of septal visible tiny nodules;12 cases were Interstitial pulmonary lobular hyperplasia and （or） core nodules;32 cases were mild pleural thickening and irregular multiple small nodules;31 cases were hilar and （or） mediastinal lymph nodes; 25 cases were small lung nodules or patchy opacities; 29 cases of pleural fluid; 12 cases were mild pericardial thickening and （or） a small amount of fluid. Conclusion To some certain, the CT findings which the markings irregular thickening with multiple small nodules, pulmonary septal thickening with multiple small nodules, mild pleural thickening with multiple small nodules, is characteristic for the diagnosis of pulmonary lymphangitic carcinomatosis. And spiral CT is an effective method to the diagnosis of pulmonary lymphangitic carcinomatosis.