特殊背景下肺癌CT征象的分析研究

Analysis of CT signs of lung cancer in special background

目的探讨特殊背景下发生肺癌的CT征象特点,提高对特殊背景下肺癌的诊断水平。方法回顾分析经手术证实的93例肺癌患者CT图像,图像征象的分析主要包括肿瘤病灶的形态形状、分布位置、内部特点、边缘等及病灶的动态变化。结果 93例肺癌患者中,有33例为肺间质纤维化背景下发生,本组病例中有29例(87%)病灶位于肺外周带,4例位于肺内中带,且有17例(51%)病灶呈不规则形状,18例(49%)表现为典型结节;有20例发生于肺大疱背景下,其中10例(50%)表现为肺泡壁的不均匀增厚,5例(25%)表现为壁结节,5例(25%)表现为均匀增厚;有40例患者为肺结核背景下发生,其中20例(50%)发生于陈旧结核灶内部,表现为不规则结节状,6例(15%)发生于不张的肺组织内,8例(20%)表现为厚壁空洞,6例(15%)病灶的发生于结核灶之外。结论特殊的背景发生肺癌的发病率较高,而复杂的背景往往容易造成肺癌的漏诊、误诊,通过对于CT征象细节的分析可以进一步提高对于特殊背景下肺癌的认识。

Objective To investigate the characteristics of CT signs of lung cancer under special circumstances and to improve the diagnosis of lung cancer in special settings. Methods CT images of 93 cases with lung cancer confirmed by surgery were retrospectively analyzed. Image analysis mainly included the morphological shape, distribu- tion location, internal features, borders, and dynamic changes of the lesions. Results Among the 93 lung cancer pa- tients, 33 cases occurred in the background of pulmonary fibrosis. In this group, 29 cases＇ （87%） lesions located in the peripheral pulmonary zone, 4 were located in the middle lung zone, and 17 cases＇ （51%） lesions were irregularlyshaped, 18 cases （49%） showed typical nodules; 20 cases occurred in the context of bullae, 10 cases （50%） showed uneven thickening of the alveolar wall, 5 cases （25%） showed nodular nodules, 5 cases （25%） showed uniform thick- ening; 40 cases occurred in the background of tuberculosis, and 20 cases （50%） occurred in the old tuberculosis area, showing no nodule was regular, 6 cases （15%） occurred in the atelectasis lung tissue, 8 cases （20%） showed thick- walled holes, and 6 cases （15%） lesions occurred outside the tuberculosis. Conclusion The incidence of lung cancer with a special background is high, but the complex background usually cause missed diagnosis and misdiagnosis of lung cancer. The analysis of the CT signs can further improve the understanding of lung cancer in a special context.