肺内球形灶棘突CT征与病理对照研究

Spinous Protuberant Sign of Pulmonary Spherical Lesions on CT Scan: A Comparison with Pathology

目的 探讨肺内球形灶棘突CT征的病理基础及诊断价值。资料与方法 选择 2 7例肺内棘突CT征进行病理对照研究 ,病灶大小为 3～ 6cm。全部病例均经肘静脉注射对比剂后 ,从肺尖至肺底扫描 ,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 0 .5～1.0cm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 2 7例棘突CT征分为两型 :(1)中央型 ,13例 ;(2 )周围型 ,14例。其中 2 2例为肺癌 ,1例为转移性肺癌 ,4例为良性病变。

Objective To explore the pathological basis and the diagnostic value of spinous protuberant sign on CT in pulmonary spherical lesions.Materials and Methods CT spinous protuberant sign in 27 cases was compared with the pathological results. The pulmonary lesions were 3～6cm in diameter. The scanning was done after intravenous injection of contrast media on an Elscient CT Twin unit or a GE Prospeed unit, using 10mm intervals and covering from the apes to the lung base. Additional 3～5mm thin slices were made according to the lesion size. The pathological specimens were fixed in accordance with Heitzman method and sectioned transversely at 0.5～1.0cm intervals in same plane as the CT scan. The region of interest was observed microscopically, and a comparison was made with CT signs. Results On CT, the spinous protuberant sign in 27 cases could be divided into two types: central type (n=13) and peripheral type (n=14). The pulmonary lesions in 27 cases included cancer (n=22), metastasis (n=1) and benign lesion (n=4).Conclusion The spinous protuberant sign of spherical lesions on CT scan is valuable in diagnosing malignant pulmonary tumors.