肺部转移瘤的发生情况及多层螺旋CT诊断价值

The Occurrence of Pulmonary Metastases and the Diagnostic Value of Multislice Spiral CT

目的分析肺部转移瘤的发生情况及多层螺旋CT(MSCT)诊断价值。方法选取2015年7月至2017年8月我院行MSCT检查的62例肺部转移瘤病变患者为研究对象,分析其原发灶类型、转移类型及MSCT中病灶边缘、形态、内部结构等影像特征,并以病理结果为金标准,评估MSCT的诊断效能。结果 62例患者经病理证实肺部转移瘤60例,良性病变2例,原发灶类型:消化系统31例(51.67%)、呼吸系统恶性肿瘤13例(21.66%)、乳腺恶性肿瘤10例(16.67%)、其他6例(10.00%),转移类型:弥漫转移型20例(33.33%)、多发转移型33例(55.00%)、单发转移型7例(11.67%);MSCT检查中,出现分叶征25例(40.32%)、毛刺征13例(20.97%)、晕征2例(3.23%)、钙化4例(6.45%)、支气管征象6例(9.68%);MSCT增强扫描诊断肺部转移瘤的灵敏度、准确度均明显高于MSCT平扫(P<0.05),而特异度比较差异无统计学意义(P>0.05)。结论肺部转移瘤主要发生在消化系统、呼吸系统等恶性肿瘤中,且以多发转移较常见,采用MSCT检查有一定影像特征,尤其是MSCT增强扫描具有较高诊断效能,值得在临床推广应用。

Objective To analyze the occurrence of pulmonary metastases and the diagnostic value of multislice spiral CT（MSCT）. Methods A total of 62 patients with pulmonary metastases which examined by MSCT during the period from July 2015 to August 2017 were selected as the subjects. The types of primary lesions, types of metastases and MSCT image features, such as the edge, shape and internal structure of lesions were analyzed. The diagnostic efficiency of MSCT was evaluated with pathological findings as the golden standard. Results Among the 62 patients, 60 cases with lung metastases and 2 cases with benign lesions were confirmed by pathology. The types of primary tumors were digestive system in 31 cases（51.67%）, respiratory system malignant tumors in 13 cases, malignant breast tumors in 10 cases（16.67%） and the other 6 cases（10.00%）. Types of metastases included diffuse metastases in 20 cases（33.33%）, multiple metastases in 33 cases（55.00%） and single metastasis in 7 cases（11.67%）. MSCT examination showed that there were lobulated signs in 25 cases（40.32%）, spicule signs in 13 cases（20.97%）, halo signs in 2 cases（3.23%）, calcification in 4 cases（6.45%） and bronchial signs in 6 cases（9.68%）.The sensitivity and accuracy of MSCT enhanced scan in diagnosing pulmonary metastases were significantly higher than those of MSCT plain scan（P〈0.05）, but there was no statistically significant difference of specificity（P〉0.05）. Conclusion Pulmonary metastases mainly occur in digestive system, respiratory system and other malignant tumors, and multiple metastases are more common. Image features of MSCT scan are characteristic, and the diagnostic efficiency of MSCT enhanced scan is high.