中央型肺鳞癌不同分型MSCT影像学表现特征分析

Imaging Characteristics of Different Types of Central Lung Squamous Cell Carcinoma in MSCT

目的分析中央型肺鳞癌不同分型多层螺旋CT(MSCT)影像学表现特征。方法选取本院2016年7月至2019年11月收治的60例中央型肺鳞癌患者作为研究对象。观察肿瘤位置、大小、形态、有无囊变坏死、与周围组织关系及强化程度等影像学特征。结果60例中央型肺鳞癌患者经MSCT检查,Ⅰ型8例,Ⅱ型39例,Ⅲ型13例。其中Ⅰ型肿瘤最小径0.56cm,肿瘤最大径1.82cm,增强扫描呈中度强化,强化多均匀。Ⅱ型肿瘤最小径2.14cm,肿瘤最大径9.53cm。肿瘤形态多不规则,23例伴有阻塞性肺炎。11例边缘呈分叶状,其中2例可见气-液平面。9例可见小灶性偏心钙化。增强扫描呈轻中度强化,强化均匀或不均匀。Ⅲ型CT显示肿瘤支气管腔内铸形生长,邻近支气管可见不规则增粗,边缘多光整。增强扫描呈中度强化,11例可见分枝状影与肺动脉伴行,5例可见树芽征;6例可见斑片状无强化区,考虑为粘液嵌塞。结论MSCT检查可有效显示中央型肺鳞癌的影像学特征,其不同分型CT征象具有一定特征性,可为临床定性诊断提供可靠的依据。

Objective To analyze the imaging characteristics of different types of central lung squamous cell carcinoma in multi-slice spiral CT(MSCT).Methods 60 patients with central lung squamous cell carcinoma treated in our hospital from July 2016 to November 2019 were selected as the research subjects.The imaging features such as tumor location,size,morphology,cystic degeneration and necrosis,relationship with surrounding tissues,and degree of enhancement were observed.Results Sixty patients with central lung squamous cell carcinoma were examined by MSCT.8 cases belonged to typeⅠ,39 cases belonged to typeⅡ,and 13 cases belonged to typeⅢ.The smallest diameter of tumor in typeⅠwas 0.56cm,and the largest diameter of tumor was 1.82cm.The enhancement scan showed moderate enhancement,and the enhancement was uniform.The smallest diameter of tumor in typeⅡwas 2.14cm,and the largest diameter of tumor was 9.53cm.The tumors were irregular in shape and 23cases were accompanied by obstructive pneumonia.The edges of 11 cases were lobulated,and 2 cases showed gas-liquid plane.9 cases showed small focal eccentric calcification.Enhanced scans showed mild to moderate enhancement,the enhancement was uniform or uneven.TypeⅢCT showed the tumor cast grows in bronchus.The adjacent bronchus was irregularly thickened,and the edges were mostly smooth.The enhanced scan showed moderate enhancement.11 cases showed branched shadows accompanied by pulmonary arteries,and 5 cases showed tree-in-bud.6 cases showed patchy non-reinforced areas,considering mucoid impaction.Conclusion The MSCT examination can effectively display the imaging characteristics of central lung squamous cell carcinoma.The CT signs of different types have its characteristics,which can provide a reliable basis for clinical qualitative diagnosis.