囊腔类肺癌的CT表现特点分析

CT FINDINGS OF CYSTIC LUNG CANCER

目的分析囊腔类肺癌的CT表现特点,提高对该疾病的认识和诊断准确率。方法回顾性分析45例经病理证实的囊腔类肺癌病人的临床资料和影像表现。结果45例病人中,病灶位于右肺28例(62.2%),位于左肺17例(37.8%);病理证实为腺癌41例(91.1%),鳞癌4例(8.9%)。所有CT征象中检出率超过50%的有:圆形或类圆形32例(71.1%),囊腔单发25例(55.6%),囊腔内壁毛糙26例(57.8%),壁结节24例(53.3%),腔内有分隔30例(66.7%),分叶征29例(64.4%),毛刺征28例(62.2%),血管集束征23例(51.1%),胸膜凹陷征32例(71.1%)。依据Mascalchi分型,Ⅳ型最多(20例),Ⅱ型最少(3例)。动态随访了14例病人,6例CT形态发生明显变化,主要表现为囊腔扩大、囊壁增厚、结节增大。结论囊腔类肺癌是一类特殊类型的肺癌,薄壁囊腔、壁结节、囊腔内分隔为其特殊的CT表现,仔细观察及动态随访有助于早期、准确地诊断该疾病。

Objective To investigate the CT findings of cystic lung cancer,and to improve the awareness and diagnostic accuracy of this disease.Methods A retrospective analysis was performed for the clinical data and imaging findings of 45 patients with pathologically confirmed lung cancer associated with cystic airspaces.Results Among the 45 patients,28(62.2%)had 1esions in the right lung and 17(37.8%)had lesions in the left lung,and pathological examination confirmed that 41(91.1%)had adenocarcinoma and 4(8.9%)had squamous cell carcinoma.CT signs with a detection rate of>50%were round or oval shape in 32 patients(71.1%),single cyst in 25 patients(55.6%),irregular inner wall in 26 patients(57.8%),mural nodule in 24 patients(53.3%),septum in cystic airspace in 30 patients(66.7%),lobulation sign in 29 patients(64.4%),spiculation sign in 28 patients(62.2%),vascular convergence sign in 23 patients(51.1%),and pleural indentation sign in 32 patients(71.1%).Based on the typing system proposed by Mascalchi,typeⅣ(20 patients)was the most common type and typeⅡ(3 patients)was the least common type.Dynamic follow-up was performed for 14 patients,and 6 showed significant changes on CT,mainly enlarged cystic airspace,cyst wall thickening,and enlarged wall nodules.Conclusion Cystic lung cancer is a special type of lung cancer with the special CT findings of thin-walled cystic airspace,mural nodules,and septum in cystic airspace.Careful observation and dynamic follow-up can help to make an early and accurate diagnosis of this disease.