肺癌的CT诊断

CT Evaluation of Bronchogenic Carcinoma

目的 :探索周围型肺癌的CT征象 ,评价肺癌的CT诊断准确性。材料和方法 :收集经CT检查并病理证实的1418例肺癌 ,其中周围性肺癌788例 ,中央型肺癌517例 ,弥漫性肺癌24例 ,多原发性肺癌14例 ,原发灶不明者75例。CT诊断结果与病理作对照 ,并对周围型肺癌的各种征象进行分析。结果 :1393例诊断正确 ,准确率为98.2 % ;25例诊断错误 ,误诊率为1.8 %。分叶征、毛刺征和胸膜凹陷征出现率分别占周围型肺癌的56.9 %、46.2 %和35.0 % ,是周围型肺癌最常见的征象 ;空泡征出现率17.1 % ,在<3cm的肺癌中为64.9 %。增强后强化值以20Hu为阈值对周围性肺癌诊断的敏感性达96.3 % ,以15Hu为阈值 ,则敏感性为100 %。结论 :分叶征、毛刺征、典型胸膜凹陷征及强化征提示周围型肺癌 ;CT征象的综合诊断可提高肺癌的诊断准确率。

Purpose:To explore CT manifestion of peripheral lung cancer and evaluate CT diagnostic accuracy of CT in lung cancer.Materials and methods:1418 cases of pathologically proved lung cancer were involved,with 788 peripheral,517 central,24 infiltrative,14 multifocal lesions and 75 others.CT diagnoses were compared with pathology and features of peripheral cancer were analysed.Results:Of all 1418 cases,the diagnostic accuracy rate was 98.2%(1393/1418),and the misdiagnostic rate was 1.8%(25/1418).Lobulation,spicular and pleural idendation were the most important sign of peripheral lung cancer,occurring in 56.9%,46.2% and 35.0% of the cases,respectively.Vocule sign was observed in 17.1% of peripheral bronchogenic carcinoma,whereas in 64.9% of <3cm lession.Contrast enhancement was useful to differentiate malignant nodule from benign ones.The sensitivity was 96.3% and 100% with 20Hu and 15Hu enhancement value as threshold respectively.Conclusion:Lobulation,spiculate,pleural indentation and contrast enhamcement are the most important sign of peripheral lung cancer.The comprehensive analysis of CT features may improve the diagnostic accuracy of lung cancer.