肺内球形灶多结节聚合CT征与病理对照研究

Multi-nodule Accumulation of Pulmonary Spherical Foci: A Comparison of CT Signs with Pathological Findings

目的 探讨肺内球形灶多结节聚合CT征的病理基础及诊断价值。材料与方法 选择 9例肺内球形灶多结节聚合CT征进行病理对照研究 ,所有病灶大小为 3～ 6cm。机型为ElscientCTTwin和GEProspeedCT机。 9例均经肘静脉注射对比剂后 ,从肺尖扫描至肺底 ,层厚 10mm ,依病灶大小 ,加扫薄层 3～ 5mm ,手术标本按Heitzman法制作 ,根据CT横断扫描特点 ,将标本病灶部分进行横断 ,作 5～ 10mm厚组织切片 ,然后 ,对“兴趣区”取材作石蜡切片 ,HE染色 ,光镜观察 ,进行病理对照。结果 9例肺内球形灶多结节聚合CT征分为 2型 :A型 ,呈桑葚形 ,5例 ;B型 ,呈宝塔形 ,4例。除B型 1例外 ,其他 8例均为肺癌。

Objective To explore the pathological basis of the CT signs of multi nodule accumulation of pulmonary spherical foci, and to evaluate these signs in clinical diagnosis. Materials and Methods CT signs of multi nodule accumulation of pulmonary spherical foci in 9 cases were compared with the pathological results. All foci were 3～6 cm in diameter. CT scan was performed on Elscient CT Twin unit or GE Prospeed unit, with an interval of 10 mm and the coverage from the apex to the base of lung, and intravenous injection of contrast media was adopted. Additional 3～5 mm thin slice scan was made according to the size of the focus. The pathological specimens were fixed using Heitzman method and cut transversely, in accord with CT scan, at 0.5～1.0 cm interval. The microscopic examination of the region of interest was performed, and the result was compared with CT sign.Results The multi nodule accumulation CT sign could be divided into two types: type A mulberry shape and type B pagoda shape. All cases were proved to be lung cancer except one case in type B.Conclusion The multi nodule accumulation CT sign is valuable for the diagnosis of malignant lung tumor.