小细胞肺癌CT影像特点分析

目的 探讨小细胞肺癌(SCLC)的典型CT影像表现及鉴别诊断.方法 收集经临床病理证实的SCLC患者29例,分析、总结不同部位SCLC的影像特征.结果 29例SCLC患者CT影像显示,中央型11例,其中Ⅰ型1例,Ⅱ型5例(Ⅱa型1例、Ⅱb型4例),Ⅲ型5例(Ⅲa型1例、Ⅲb型4例、Ⅲc型0例);周围型12例,其中位于亚段支气管周围(肺门旁)5例,形态多样(多结节状3例、纺锤状1例、分叶状1例),亚段支气管以下7例(分叶状结节/肿块5例,类圆形结节2例);弥漫实变型5例,类炎症型1例.结论 中央型SCLC为肺门融合性肿块、易向肺内延伸;亚段支气管周围肿块定位模糊,但影像学具有特征性;周围型(亚段支气管以下)SCLC为孤立性结节或肿块,鉴别诊断有一定困难.

Objective To investigate the typical CT imaging findings and differential diagnosis of small cell lung cancer(SCLC).Methods Twenty-nine patients with SCLC confirmed by clinical pathology were collected to analyze and summarize the imaging features of SCLC in different sites.Results CT images of 29 patients with SCLC showed 11 cases of central type,including 1 case of type 1,5 cases of type Ⅱ(1 case of type Ⅱ a,4 cases of type Ⅱ b),5 cases of type Ⅲ(1 case of type Ⅲa,4 cases of type Ⅲb,4 cases,Type Ⅲc 0 case).There were 12 cases of peripheral type,including 5 cases around the bronchus(parasal)of the sub-segment,with various forms(3 cases with multiple nodules,1 case with spindle shape,1 case with lobulated shape),and (7 cases with sub-bronchial bronchus(leaf)5 cases of nodular masses/lumps,2 cases with round nodules).5 cases with diffuse consolidation and 1 case with inflammation.Conclusion The central type of SCLC is a hilar fusion mass and easy to extend into the lung the sub-bronchial mass is blurred in the sub-portal,but the imaging is characteristic the peripheral type(below the sub-bronchial)SCLC is an isolated nodule or mass,differential diagnosis.There are certain difficulties.