MSCT对含囊腔型肺癌的诊断价值

Diagnostic value of multi-slice CT in cystic lung cancer

目的分析含囊腔型肺癌的多层螺旋CT(MSCT)表现,加深对此类肺癌的影像学认识。方法回顾性分析29例经病理证实的含囊腔型肺癌患者的CT影像资料。所有患者均行MSCT扫描并进行多平面重组(MPR)后处理,根据主体病变密度不同,将其分成3型,分析主体病变与囊腔的位置关系及其周围伴随征象的影像学特征;随访患者评价MSCT的动态变化。结果29例中,表现为Ⅰ型(磨玻璃密度灶伴囊腔)有8例(27.6%),其中磨玻璃密度灶中有5例表现为磨玻璃结节;Ⅱ型(实性结节伴囊腔)15例(51.7%);Ⅲ型(磨玻璃、实性结节混合病灶伴囊腔)6例(20.7%)。表现为主体病变(磨玻璃密度灶/实性结节)伴偏侧性囊腔者26例(89.7%),其余3例表现为磨玻璃灶伴中央型囊腔;11例随访病例中,6例发现实性成分体积增大、密度增高,8例囊腔增大、壁增厚;6例初期检查无囊腔,随访过程中出现囊腔。结论含囊腔型肺癌的MSCT表现有一定的特征性;结节伴偏侧性囊腔是含囊腔型肺癌较典型的影像表现,综合分析主体病变、囊腔及其伴随征象并结合影像上动态变化特点可做出较为准确的诊断。

Objective To analyze the diagnostic value of multi-slice spiral CT (MSCT) in cystic lung cancer. Methods MSCT of 29 patients with cystic lung cancer confirmed by pathology was retrospectively analyzed. The relationship between the location of the lesion and the cyst as well as the surrounding imaging features were analyzed. Results The tumors appeared as ground glass opacities with cystic cavities (8/29, 27.6%), 5 of which were ground glass nodules within the ground glass opacities. Other appearances included solid nodules with cystic cavities (15/29, 51.7%), mixed ground glass opacities and solid nodules with cystic cavities (6/29, 20.7%). The cysts were peripheral (26/29, 89.7%) or central (3/29, 10.3%). Follow-up showed enlarging solid components with increasing density (6/11), enlarging cysts with mural thickening (8/11) and cystic change in initially solid nodules (6/11). Conclusion Solid nodule with peripheral cystic cavity is a typical MSCT appearance of cystic lung cancer. Analyzing the imaging features of the main lesion and cyst with follow-up can aid imaging diagnosis.