早期中央型肺癌MSCT诊断及漏误诊的分析

Analysis of MSCT Diagnosis and Misdiagnosis of Early Central Type Lung Cancer

目的:探讨早期中央型肺癌的多排螺旋CT的征象、诊断及漏误诊原因,以提高早期中央型肺癌的MSCT诊断水平。方法:对29例由病理证实的早期中央型肺癌的CT资料分析MSCT的主要征象、诊断及漏误诊的因素。结果:CT诊断或拟诊中央型肺癌24例,肺炎1例,支气管扩张伴感染1例,结核1例,漏诊2例,并分析出漏误诊病例的原因。早期中央型肺癌主要CT表现有:支气管腔内结节,支气管管壁的增厚、管腔的狭窄,支气管铸型阴影,阻塞性肺炎与肺不张等。结论:早期中央型肺癌的MSCT检查、多维重建及熟悉CT主要征象对发现早期病变并准确诊断具有重要意义,熟悉掌握支气管的CT解剖结构、良好的读片观察习惯、仔细重建有利于提高早期中央型肺癌的诊断。

Object： To investigate the MSCT signs, diagnosis and misdiagnosis causes of early central lung cancer in order to improve the MSCT diagnostic level of early central lung cancer. Methods： CT data of 29 cases of early central type lung cancer confirmed by pathology were analyzed and the main features, diagnosis and misdiagnosis factors of MSCT were analyzed. Results： CT diagnosis or diagnosis of central lung cancer in 24 cases, pneumonia in 1 case, bronchial dilatation with infection in 1 case, tuberculosis in 1 case, missed diagnosis in 2 cases, and analysis of the causes of misdiagnosis cases. In early stage, the main CT features of the central lung cancer include： the bronchial lumen, the thickening of the bronchial tube wall, the lumen of the stenosis, bronchial casts shadow, obstructive pneumonia and pulmonary stenosis, etc. Conclusion： Early central lung cancer with MSCT, multidimensional reconstruction and CI main signs to find the disease early and accurate diagnosis is of great significance, familiar with CT of bronchial anatomy structure, good read piece habits of observation, careful reconstruction is helpful to improve the diagnosis of early central lung cancer.