不典型肺癌CT诊断与鉴别诊断

CT diagnosis and differential diagnosis of atypical lung cancer

目的探讨不典型肺癌CT征象,提高肺癌诊断水平,减少误诊、漏诊发生。方法回顾性分析2018年1月~2019年12月经病理证实18例不典型肺癌临床表现及CT平扫、增强资料,加以分析,总结,提炼其CT图像特征。结果空泡征、蜂窝征10例;毛刺征、分叶征、胸膜凹陷征3例;支气管扭曲、狭窄、阻断、分叉角度增大5例,增强扫描见血管集束征及血管造影征。结论不典型肺癌CT征象仍有一定规律可循,仔细观察病灶CT直接特征以及支气管、血管、淋巴管间接征象,一般均能做出明确诊断。

Objective To explore the CT features of atypical lung cancer in order to improve the diagnostic level of lung cancer and reduce the occurrence of misdiagnosis and missed diagnosis.Methods The clinical manifestations and the data of plain scan and enhanced scan of CT of 18 cases with atypical lung cancer confirmed by pathology from January 2018 to December 2019 were retrospectively analyzed and summarized,and the CT image characteristics were refined.Results There were 10 cases with vacuole sign and honeycomb sign,3 cases with spiculation sign,lobulation sign and pleural indentation sign,and 5 cases with bronchial distortion,stenosis,occlusion and increased bifurcation angle.Vascular bundle sign and angiographic sign were found under enhanced scan.Conclusion For CT features of atypical lung cancer,there are still certain rules to follow.Careful observation of direct CT features of lesions and indirect signs of bronchi,blood vessels and lymphatic vessels can generally help to bring about a clear diagnosis.