周围型小细胞肺癌的CT征象分析

Analysis of CT Signs of Peripheral Small Cell Lung Cancer

目的探讨周围型小细胞肺癌的CT特征。方法回顾性分析11例周围型小细胞肺癌CT表现,10例行CT平扫+三期增强,1例行CT平扫+常规增强。结果10例单发,1例多发,共12个病灶。10例男性。年龄52~80岁,中位值67岁。卵圆形或椭圆形者10例,“分叶”征9例,边缘光滑者10例,边缘毛糙者1例,胸膜“凹陷”征2例,胸腔积液和/或胸膜增厚者6例,钙化2例,血管“集束”征1例,小血管“贴边”征和/或“包埋”征8例,周围小叶间隔增厚征4例,支气管血管束“增厚”征6例。CT三期增强上7例呈缓慢进入渐进性轻-中等度强化,3例呈快速进入持续性中等度强化;7例强化峰值出现在静脉期,其中3例于延迟期稍廓清;3例强化峰值出现在延迟期;静脉期9例不均匀强化,其中7例呈“沼泽样”强化、2例呈中央区斑片状局灶性低密度坏死,2例呈较均匀强化。双肺门+纵隔淋巴结肿大者2例,单肺门+纵隔淋巴结肿大者4例,单肺门淋巴结肿大者2例,无肺门及纵隔淋巴结肿大者3例。结论周围型小细胞肺癌的CT征象具有一定特点。

Objective To analyze the CT features of peripheral small cell lung cancer.Methods 11 cases of small cell lung cancer diagnosed by pathology were retrospectively analyzed.Ten cases underwent plain CT scan+three stage enhanced CT,and one case underwent plain CT scan+conventional enhanced CT.Results 10 cases were single and 1 case was multiple and there were 12 focus in total.There were 10males and 1 female.The age ranged from 52 to 80 years old,with a median age of 67.The maximum diameter of axial position was 25.61mm~65.04mm,and the median value was 34.42mm.10 cases were oval or oval,9cases showed lobulation sign,10 cases showed smooth edges,the margin was rough in 1 case,2 cases showed pleural indentation sign,6 cases showed pleural effusion and/or pleural thickening,2 cases showed calcification,8 cases showed small vessel welt sign and/or embedding sign,4 cases showed peripheral septal thickening sign,marginal GGO sign was not found,6 cases showed bronchial blood vessel bundle thickening.On three stage enhanced CT,7cases showed slow progression gradual light to medium enhancement,and 3 cases showed rapid progression continuous medium enhancement.In 7 cases,the enhancement peak appeared in the venous phase,and in 3 cases,it was slightly cleared in the delayed phase.In 3 cases,the enhancement peak appeared in the delay period.There were 9 cases of uneven enhancement in the venous stage,including 7 cases with"swamp-like"enhancement,2 cases with patchy focal low-density necrosis in the central area.2 cases showed relatively uniform enhancement.There were 2 cases with bilateral hilar and mediastinal lymph node enlargement,4 cases with single hilus and mediastinal lymph node enlargement,2 cases with single hilus and mediastinal lymph node enlargement,and 3 cases without hilus and mediastinal lymph node enlargement.Conclusion There were some certain characteristics on CT findings of peripheral small cell lung cancer.