支气管肺类癌的CT表现及文献回顾

CT findings and literature review of bronchial carcinoid

目的探讨支气管肺类癌的CT表现,为临床诊断提供更多信息。方法回顾性地分析我院8例经病理证实的支气管肺类癌患者的CT资料及临床表现,并复习相关文献。结果8例CT表现均为肺内单发病灶,其中周围型2例,中央型6例,病理证实非典型类癌2例,典型类癌6例;6例边界清楚,且密度多均匀;2例呈分叶状,1例边缘毛糙、伴短毛刺;5例病灶内部见钙化灶,1例病灶内见脂肪成分,1例见少量胸积液;5例肿块表现为“冰山征”,2例表现为支气管腔内结节,1例病灶边缘毗邻支气管分支;6例出现阻塞性肺不张或肺实变;增强扫描5例强化较明显,CT值升高≥30HU,其中2例不典型类癌强化不均匀,2例见可见强化血管影;3例呈轻-中度强化表现。结论支气管肺类癌的CT表现具有一定特征性,对于临床诊断有一定价值,但其确诊多需要依靠病理检查。

Objective To investigate the CT findings of bronchial carcinoid and to provide more information for clinical diagnosis.Methods The CT findings and clinicaldata were retrospectively analyzed in 8 patientsconfirmed by biopsy.Results All the 8 cases manifested as single round mass on CT images,including 2 peripheral lesions and 6 central lesions.It was proved that 2 atypical tumors and 6 typical tumors.CT findings of these cases consisted of well-defined border and uniform density(6 cases),lobulated contour(2 cases)and rough margin with short burr(1 case).5 cases contained calcification,1 case contained fat component and 1 case contained a small amount of pleural lesionscould present as an“iceberg sign”(5 cases),intra-bronchial nodule(2 cases)or near the edge of the bronchus(1 case).The obstructive atelectasis or pulmonary consolidation was found in 6 cases.On CT contrast scanning,these lesions presented relatively significant enhancement(5 cases),usually the CT value increased≥30HU,in which 2 cases of atypical carcinoid were inhomogeneous enhancement,and 2 cases showed enhanced vascular and mild to moderte enhancement(3 cases).Conclusion The CT findings of bronchial carcinoid have certain characteristics,which are certain value for clinical diagnosis,but the final diagnosis mostly depends on pathology.