肺炎型肺腺癌CT影像学表现

CT manifestations of pulmonary adenocarcinoma of pneumonia type

目的探讨肺炎型肺腺癌在CT影像特征性表现,提高诊断率。方法选取53例经病理确诊肺炎型肺腺癌临床及CT影像资料,按病灶分布分为局灶性和弥漫性,采用统计学χ^(2)检验统计组间差异。结果肺炎性肺腺癌以外周分布为主,常伴有分叶征、支气管气象,血管造影征,但组间无差异;局灶性病例27例,以磨玻璃,单纯实变较多,部分阴影内出现空泡影,弥漫性病例26例,以混合性及实变并纤维化、肿块为主,组间对照,弥漫性病灶周围更容易伴发结节影、网格阴影伴磨玻璃影,纵膈淋巴结增大,胸水征象;随访发现病灶分布由局灶性向弥漫性进展,形态从单一向混合形态进展。结论肺炎型肺腺癌呈局灶性及弥漫性分布,当实变内有空泡影、蜂窝影、周围有结节、周围网格伴磨玻璃影时,诊断肺炎型肺癌较为可靠,CT的动态复查对该病诊断具有指导意义。

Objective To investigate the characteristic CT features of pulmonary adenocarcinoma of pneumonia type so as to improve the efficiency of clinical image diagnosis.Methods We retrospectively analyzed the clinical and CT imaging data of 53 cases of pneumonic lung adenocarcinoma confirmed by pathology,and divided them into focal and diffuse groups according to the distribution.The difference between the groups was counted by statisticalχ^(2) test.Results Pneumonic lung adenocarcinoma was mainly peripherally distributed,often accompanied by lobulated signs,bronchial meteorology,and angiography signs,but there was no difference between the groups;There were 27 cases of focal cases,exhibiting ground glass,simple consolidation,partial shadow,with empty bubbles inside.There were 26 cases of diffuse cases,mainly mixed and consolidation with fibrosis and masses.Between groups,the diffuse lesions were easily accompanied by nodular shadows,grid shadows and ground glass shadows,and the mediastinum enlarged lymph nodes,signs of pleural effusion;follow-up found that the lesion distribution progressed from focal to diffuse,and the shape progressed from a single to a mixed shape.Conclusion The lung adenocarcinoma of pneumonia type is distributed in a focal and diffuse way.When there is empty bubble shadow,honeycomb shadow,surrounding nodule and surrounding grid with ground glass shadow in consolidation,the diagnosis of lung cancer of pneumonia type is more reliable.Dynamic CT reexamination has guiding significance for the diagnosis of pneumonic lung cancer.