肺转移瘤高分辨率CT表现

The performance of pulmonary metastases on HRCT

目的通过分析肺转移瘤在高分辨率CT(HRCT)上的表现情况,从而提高对肺转移瘤诊断的准确性。方法收集经HRCT诊断并经病理或临床随访确诊为肺转移瘤的病例共109例,回顾性分析肺转移瘤所处的解剖部位,病灶数目、大小、形态、密度等情况。结果本研究共收集到HRCT扫描并确诊的肺部转移瘤109例,其中单发4例,多发105例,共有2 098个病灶。结节型90例,肿块型3例,粟粒型3例,不规则型3例,癌性淋巴管炎型1例,混合型8例。转移瘤特征:分叶征37例,毛刺征28例,空洞7例,空气支气管征12例,晕征3例,磨玻璃密度1例。病灶平均大小为(5.0±3.6)mm,四分位数间距(2.80～5.70)mm。病灶分布部位:左肺947个,右肺1 151个;上肺野:301个,中肺野:1 345个,下肺野:452个;肺内带567个,肺中带627个,肺外带904个。结论肺转移瘤在HRCT上有多种多样的表现形式,不同的原发肿瘤肺部转移在形态及分布上也各有特点,掌握这些特征表现,对于肺转移瘤的诊断将会有更大的帮助。

Objective To analyze the performance of the lesions on HRCT. The accuracy of diagnosis of pul- monary metastases will be improved. Methods A total of 109 cases with pulmonary metastases which were diagnosed by HRCT and pathology or clinical follow-up were collected. The anatomic sites, number, size, shape and density of le- sions were retrospectively analyzed. Results In this study, a total of 109 pulmonary metastatic tumors detected and diagnosed by HRCT were collected, of which 4 cases were single, and 105 cases were multiple. In all, there were 2 098 lesions. There were 90 cases with nodular type, 3 cases with mass type, 3 cases with millet type, 3 cases with ir- regular type, 1 case with cancerous lymphangitis, and 8 cases with mixed type. Characteristics of metastatic tumors： 37 cases with Iobular sign, 28 cases with spicule sign, 7 cases with cavitation, 12 cases with air bronchogram, 3 cases with halo sign, 1 case of ground glass density. The average size of the lesions was （5.0±3.6） mm and the interquartile range was （2.80-5.70） mm. The distribution of the lesions： 947 cases of left lung, 1 151 cases of right lung; 301 cases of upper lung fields, 1 345 cases of middle lung fields, 452 cases with lower lung fields; 567 cases with inner lungs zones; 627 cases with middle lungs zones; 904 cases with outer lung zones. Conclusion Pulmonary metastases have a variety of manifestations on HRCT. The lung metastases of different primary tumors also have their own characteristics in mor- phology and distribution. Grasping these characteristics will be of great help in the diagnosis of pulmonary metastases.