肺原发性类癌CT影像分析

CT imaging analysis of primary lung carcinoid tumors

目的分析肺原发性类癌的CT影像学特征,提高对该病的诊断准确率。方法收集经病理证实肺原发性类癌19例,回顾性分析其临床及CT表现。其中17例完成CT增强扫描,2例仅CT平扫。结果所有病例均为单发,13例表现为边界光滑的类圆形孤立结节或肿块影,3例为长条状沿血管支气管束走行,17例边界光滑圆润;10例密度均匀,4例内部可见钙化,3例见小囊状低密度影;2例表现为腔内结节-“冰山征”,伴阻塞性炎症7例,4例出现同侧及纵隔淋巴结肿大,2例累及邻近胸膜。CT增强扫描:15例出现明显强化,CT值增幅超过40 HU。仅2例呈轻度强化。本组19例均无空洞影及明显胸腔积液,2例于1年后出现远处转移征象。结论肺类癌CT表现缺乏特征性;肺内及支气管腔边界光滑的结节或肿块,增强扫描明显较均匀明显强化,“冰山征”等可提高本病的诊断准确率。

Objective To analyze the CT imaging features of lung carcinoid tumors and improve the diagnostic accuracy of this disease.Methods Nineteen cases with lung carcinoid confirmed by pathology were collected and their clinical and CT manifestations were analyzed retrospectively.Among them,17 cases completed enhanced CT scan,and 2 cases only had plain CT scan.Results All cases were single,13 cases showed round solitary nodule or mass shadow with smooth boundary,3 cases showed long strip shape along vascular bronchial bundle,17 cases had smooth and round boundary,10 cases had uniform density,4 cases had calcification inside,3 cases had small cystic low density shadow,2 case showed intraluminal nodule,2 cases had"iceberg sign",7 cases had obstructive inflammation,4 cases had ipsilateral and mediastinal lymph node enlargement,and 2 cases.Only one case showed mild enhancement.There were no obvious pleural effusion and cavity shadow in 19 cases,and 2 cases showed distant metastasis after 1 year.Conclusion CT findings of lung carcinoid are not characteristic;The nodular masses with smooth or round boundary in lung and bronchial cavity are obviously enhanced uniformly by enhanced scan,and"iceberg sign"can improve the diagnostic accuracy of this disease.