周围型小细胞肺癌多层螺旋CT影像学表现

Multi-slice spiral CT imaging findings of peripheral small cell lung cancer

目的:分析周围型小细胞肺癌(PSCLC)多层螺旋CT(MSCT)影像学表现。方法:回顾性分析2017年1月—2021年6月手术或穿刺活检病理证实为PSCLC患者46例的临床资料,分析其临床及MSCT表现。结果:46例PSCLC患者均表现为实性病变。其中结节型21例,肿块型23例,肺叶实变型2例;类圆形/圆形29例,纺锤形/蠕虫状7例,分支状10例,串珠征6例,斑块状2例;分叶征15例,毛刺征3例,胸膜凹陷征2例,指状凸起或小尾巴征8例,血管集束征0例;空泡0例,空洞1例,空气支气管征2例,钙化3例;支气管狭窄15例,支气管阻塞6例;阻塞性肺炎12例,阻塞性肺不张2例;淋巴结转移38例,远处转移13例;44例行增强扫描显示不均匀轻中度强化36例,较均匀强化8例,血管包埋征9例,血管推移征4例,血管穿行2例。结论:PSCLC的MSCT表现为类圆形/圆形实性病变,轻中度强化,早期特殊形态为纺锤形或蠕虫状、分支状、串珠征,晚期常伴有肺门、纵隔淋巴结及远处转移。

Objective:To investigate the imaging findings of peripheral small cell lung cancer(PSCLC)by multi-slice spiral CT(MSCT).Methods:All 46 patients with PSCLC who were pathologically confirmed by surgery or biopsy in hospital from January 2017 to June 2021 were retrospectively collected,and their clinical and MSCT manifestations were analyzed.Results:MSCT manifestations:46 cases of PSCLC showed solid lesions;21 cases were nodular type,23 cases were mass type,and 2 cases were lobar consolidation;29 cases were round-like or round,and 7 cases were spindle or worm-shaped,10 cases with branching,6 with beaded sign,2 with plaque;15 with lobulated sign,and 3 with spicule sign,pleural depression sign in 2 cases,finger-like protrusion or small tail sign in 8 cases,vascular cluster sign in 0 cases;vacuoles in 0 cases,cavity in 1 case,air bronchus sign in 2 cases cases,calcification in 3 cases;bronchial stenosis in 15 cases;bronchial obstruction in 6 cases;obstructive pneumonia in 12 cases;obstructive atelectasis in 2 cases;lymph node metastasis in 38 cases;distant metastasis in 13 cases;enhanced scan in 44 cases:heterogeneous There were 36 cases of mild to moderate enhancement,8 cases of more homogeneous enhancement,9 cases of vascular embedding sign,and 4 cases of vascular push sign,2 cases of blood vessels passed through.Conclusion:The MSCT manifestations of PSCLC include round-like/round solid lesions,mild to moderate enhancement,spindle-shaped or worm-like,branched and beaded signs in the early stage,and hilar,mediastinal lymph nodes and distant metastases in the late stage.