肺癌空洞的CT影像学特征及诊断价值

Computed tomography imaging features and diagnostic value of lung cancer cavity

目的探讨肺癌性空洞患者CT影像学特征及诊断价值,以提高该病术前诊断准确度。方法回顾性分析我院自2019年6月至2021年6月经穿刺或纤维支气管镜活检及手术病理证实的肺癌性空洞患者32例临床病案资料及CT扫描影像学特征。结果32例肺癌性空洞患者中,肺鳞癌26例,肺腺癌6例,32例肺癌大小均>20 mm,偏心性空洞20例(62%),壁厚且不均匀>3 mm。25例患者空洞内外壁均不光整,18例有壁结节,15例胸膜牵拉凹陷,20例纵膈淋巴结肿大。CT平扫表现空洞壁密度不均匀,CT增强表现为不均匀中度-明显强化。结论肺癌空洞的大小、形态、壁结节及CT平扫表现空洞壁密度不均匀,CT增强表现为不均匀中度-明显强化。间接征象:胸膜牵拉凹陷、纵膈淋巴结肿大等影像学特征有助于肺癌性空洞的诊断及鉴别诊断,以提高该病术前诊断准确度。

Objective To explore the Computed Tomography(CT)imaging characteristics and diagnostic value of patients suffering from lung cancer cavity,aiming to improve the preoperative accuracy of the disease.Methods A retrospective analysis was conducted for the clinical record data and the CT scan imaging char-acteristics of 32 patients with lung cancer cavity that was confirmed by puncture or fiberoptic bronchoscopy biopsy and surgical pathology in our hospital from June 2019 to June 2021.Results Among 32 patients with lung can-cer cavity,there were 26 cases of lung squamous cell carcinoma,and 6 cases of lung adenocarcinoma.All the 32 cases of lung cancer were>20 mm in size,with 20 cases of eccentric cavity(63%).The wall thickness was uneven(>3 mm).The inner and outer walls of the cavities were not smooth in 25 patients,18 cases had wall no-dules,15 cases had pleural traction depression,and 20 cases had mediastinal lymph node enlargement.CT plain scan showed that the density of the cavity wall is uneven,and the CT enhancement was uneven and moder-ately-markedly-enhanced.Conclusion The size,shape,wall nodules,and CT scan of lung cancer display une-ven wall density.CT enhancement is uneven and moderately-markedly enhanced.Indirect signs included pleural stretch depression and swollen mediastinal lymph nodes.Other imaging features are helpful for the diagnosis and differential diagnosis of lung cancer cavity,which could improve the preoperative accuracy of the disease.