55例囊腔类肺癌的CT表现及病例分析

Computed tomography features of cystic lung cancer: an analysis of 55 cases

目的:探讨囊腔类肺癌的临床特点及CT表现,提高对此类病变的诊断准确率。方法:回顾性分析2016年9月至2019年3月河北医科大学第四医院经手术病理证实的55例囊腔类肺癌患者的CT表现,总结其临床特点(包括年龄、性别、症状、吸烟史、肺气肿、部位等)、CT影像学特点(包括分型、囊腔形态、有无分隔、分叶、毛刺、胸膜牵扯征、囊壁厚度、壁结节、囊外表现等)以及病理类型。结果:55例患者中,女性19例、男性36例,平均年龄(60.6±8.2)岁。31例患者临床症状表现为咳嗽咳痰、胸痛及发热;28例有吸烟史;9例合并肺气肿;43例位于肺外周;按照Mascalchi分型,Ⅰ型12例、Ⅱ型5例、Ⅲ型20例、Ⅳ型18例;形态不规则形43例;29例出现分隔;21例出现分叶;11例有毛刺;14例出现胸膜牵扯;囊腔周围出现磨玻璃密度影28例,实性密度27例。55例患者中51例为腺癌(包括浸润性腺癌和微浸润性腺癌)、3例为腺鳞癌、1例为鳞癌。结论:囊腔类肺癌的CT表现有一定的特征性,同时伴有周围性肺癌的常见征象,结合囊腔及囊周的CT表现可以提高诊断的准确率。

Objective:To investigate the clinical characteristics and computed tomography(CT)features of cystic lung cancer to improve the diagnostic accuracy of such lesions.Methods:The CT features of 55 patients enrolled in The Fourth Hospital of Hebei Medical University from September 2016 to March 2019 with surgically and pathologically confirmed cystic lung were retrospectively analyzed.The clinical characteristics(including age,sex,symptoms,smoking history,emphysema,and location),CT features(including classification,cystic morphology,septation,lobulation,spiculation,pleural retraction sign,cyst wall thickness,nodules on the wall,and extracystic features),and pathological types were summarized.Results:Among the 55 patients,19 were females and 36 were males;the average age was(60.6±8.2)years.Thirty-one patients had clinical symptoms of cough,expectoration,chest pain,and fever.Twenty-eight patients had a smoking history.Nine patients had combined pulmonary emphysema.Forty-three lesions were located in the peripheral lung.According to the classification proposed by Mascalchi,12 patients had typeⅠlesions,5 had typeⅡ,20 had typeⅢ,18 had typeⅣ,and 43 had irregularshaped lesions.Septation was found in 29 patients,lobulation in 21,spiculation in 11,and pleural retraction sign in 14.Twenty-eight patients had cystic spaces associated with ground-glass opacities and 27 patients had lesions with a solid density.Among the 55 patients,51 had adenocarcinomas(including invasive and microinvasive adenocarcinomas),3 had adenosquamous carcinomas,and 1 had squamous cell carcinoma.Conclusions:The CT features of cystic lung cancer are characteristic and accompanied by common signs of peripheral lung cancer.Diagnostic accuracy can be improved by combining the CT features of cystic spaces and the surrounding changes.