炎症型肺浸润性黏液腺癌CT表现

CT Features of Pneumonic-type Pulmonary Invasive Mucinous Adenocarcinoma

目的探讨炎症型肺浸润性黏液腺癌的CT表现,提高对本病的认识。方法回顾性分析经手术病理或穿刺活检证实的11例炎症型肺浸润性黏液腺癌患者的临床、CT资料。结果11例中8例为多发病灶,2例为单发病灶,1例首次检查为单发病灶,6个月复查时为双肺播散。11例均见一处或多处片状实变影,其中3例为单纯性实变影,8例为实变.影伴磨玻璃影。实变影的密度不均匀,平均CT值214HU。11例中10例实变影中可见含气支气管影,含气支气管的形态不规则,表现为支气管僵直、支气管扩张、扭曲变形,2例可见局部明显增粗呈假空洞状。增强扫描后实变影强化不均匀.,大部分区域为轻中度强.化,动脉期CT值上升242HU,静脉期CT值上升236HU,2例实变影中可见局灶性的.明显强化区,10例增强扫描患者均可见血管造影征11例中1例可见胸腔积液,本组病例中没有肺门及纵膈淋巴结转移。结论炎症型肺浸润性黏液腺癌CT表现上一定的特征,CT能够为本病的诊断提供非常有用的信息。

Objective To observe CT features of pneumonic-type pulmonary invasive mucinous adenocarcinoma(PIMA).Methods The clinical and CT data of 11 patients with pneumonic-type PIMA confirmed by pathology or biopsy were analyzed retrospectively.Results Among the 11 cases,8 cases were multiple lesions,2 cases were single lesions,1 case was single lesion at the first examination,and it was double lung dissemination at the time of 6-month reexamination.One or more flake consolidation were found in 11 cases,including 3 cases of pure consolidation and 8 cases of consolidation with ground glass.The density of the real change is uneven,and the average CT attenuation is 21.4HU,In 10 of 11 cases,the air containing bronchus can be seen in the consolidation.The shape of the air containing bronchus is irregular,which is characterized by bronchial rigidity,bronchiectasis,distortion and deformation.In 2 cases,it can be seen that the local area is obviously thickened and appears as a false cavity.After contrast-enhanced scanning,the enhancement of consolidation was uneven,and most areas were mild to moderate enhancement.The CT value in arterial phase increased by 24.2HU,and that in venous phase increased by 23.6HU.Localized obvious enhancement area in consolidationwas seen in 2 cases.CT angiogram sign and pleural effusion were detected insideconsolidations in 10 and 1 cases,respectively.Here was no enlargement of hilar lungr and mediastinal lymph nodes in this group.Conclusion Pneumonic-typePIMA has certain features of CT scan.CT can provide very useful information for the diagnosis of this disease.