肺原位腺癌的超高分辨率CT表现

CT Findings of Lung Adenocarcinoma in Situ in Ultra-high-resolution Computed Tomography

目的：探讨肺原位腺癌在超高分辨率CT上的影像学特征,主要分析病灶的大小和密度。方法：将56例手术病理为肺AIS的患者纳入本研究,其中女性38例,男性18例。年龄范围24-78岁,平均51.8±12.3岁,中位年龄54.5岁。术前全部完成超高分辨率CT扫描。结果：纯磨玻璃结节41例（73.2%,41/56）,其中23例（56.1%,23/41）密度不均匀;混合磨玻璃结节15例（26.8%,15/56）,其中9例以磨玻璃为主伴内部结节状实性成分,6例实性成分呈条片状与磨玻璃混合,实性最大径4.2±1.4mm。本组病例边界均清楚,4例见胸膜凹陷征,未见毛刺征。结论：肺原位腺癌大多表现为类圆形、边界清楚的纯磨玻璃结节,且密度多不均匀;部分为混合磨玻璃结节,其中实性成分最大径不足5mm,少数可伴发胸膜凹陷征。

Purpose： To explore the imaging features of lung adenocarcinoma in situ in ultra-high-resolution computed tomography（UHRCT）. The lesion size and density were analyzed. Methods： Fifty-six patients（38 females, 18 males, age ranged from 24 to 78 yrs, mean 51.8±12.3yrs and median age 54.5 yrs） with lung adenocarcinoma in situ（AIS） confirmed by operation pathology results were included in this study. All the cases were performed ultrahigh-resolution computed tomography before operation. Results： Of 56 cases lung AIS, 41 were pure ground-glass nodules, and the ground-glass opacity in 23 of 41 cases appeared inhomogeneous; 15 lesions were characterized by mixed ground-glass nodules, 9 cases had mixed ground-glass opacity and nodular solid component, and 6 cases had mixed ground-glass opacity and patchy solid component. The maximal diameter of solid component was 4.2±1.4mm. All the lesions were well-demarcated. Pleural indentation sign was shown in 4 cases and no spiculation was shown in this group. Conclusion： The lung adenocarcinomas in situ were mostly characterized by round and well-demarcated heterogeneously pure ground-glass nodules. Some were shown as mixed ground-glass nodules with the maximal diameter of solid component less than 4mm. The pleural indentation was seen in some cases.