CT增强扫描高密度点条征在周围型肺癌诊断中的意义

The Diagnostic Value of Dot and Stripe Sign on Enhanced CT Scan in Peripheral Pulmonary Carcinoma

目的 采用CT增强扫描评价“高密度点条征”在周围型肺癌诊断中的意义。材料与方法 89例经手术或穿刺病理证实的孤立性肺结节 (直径 1～ 5cm)中 ,周围型肺癌 63例 ,良性肺结节 2 6例。分别于注射 10 0ml碘对比剂前及注射后 3 5秒、2分钟及 5分钟对病灶进行薄层系列扫描。采用纵隔窗观察病灶的强化特征 ,并进行CT 病理对照研究。结果 2 7例肺癌出现“高密度点条征” ,表现为增强后在肿块内、尤其是在其周边部出现显著高密度的点、条状影 ,所有良性结节均未见此征象。CT 病理对照证实 :该点、条状高密度影是由于癌肿内较大的血管充盈对比剂所致。结论 CT增强扫描“高密度点条征”在周围型肺癌的诊断中具有非常重要的价值 。

Objective To evaluate peripheral pulmonary carcinoma with enhanced CT scanning.Materials and Methods The authors collected 89 patients with pathologically proved solitary pulmonary nodules ( 1.1～5cm in diameter), including peripheral pulmonary carcinoma (n=63) and benign pulmonary nodules (n=26). Serial thin slice CT scanning was performed both before and 35 seconds, 2 and 5 minutes after the contrast administration. The enhancement pattern of the nodules was closely observed with mediastinal window technique, and a CT pathologic comparison was made. Results Of 63 lung cancers, 27 showed dot and stripe sign on enhanced scans, which presented as very high density dots and streaks shadow within the nodules, especially at the peripheral portion, in contrast with the benign nodules, none of which showed this sign. Comparative study between CT signs and pathologic findings showed that dot and stripe sign was produced by the contrast within the blood vessels in the carcinoma.Conclusion The dot and stripe sign on enhanced CT scans is of high value in the diagnosis of peripheral pulmonary carcinomas.