细支气管肺泡细胞癌影像表现与病理对照研究

Imaging findings and pathology study of bronchioalveolar carcinoma

目的:探讨细支气管肺泡细胞癌(BAC)的影像表现并与病理结果作对照研究,提高影像诊断的正确率。材料和方法:回顾性分析40例病理证实为BAC患者的胸部X线、CT及病理资料。结果:单发结节或肿块型21例,实变型13例,弥散结节型6例。单发结节或肿块型BAC周围型18例,中央型3例,主要征象:胸膜牵引征18例(85.7%),血管聚束征18例(85.7%),毛刺征16例(76.2%),分叶征11例(52.3%),支气管征11例(52.3%),空泡征5例(23.8%)。实变型BAC单肺段?叶实变6例,多肺段?叶实变7例,主要征象:含气支气管征9例(100%),蜂房征8例(88.9%),毛玻璃征4例(44.4%),叶间裂膨突3例(33.3%),血管聚束征3例(33.3%)。弥散结节型BAC6例,主要征象:两肺不对称、不均匀弥漫分布大小不等结节,结节融合倾向6例,结节中心透亮区(空泡征)4例(66.7%),融合结节灶内支气管征2例(33.3%),血管聚束征5例(83.3%),胸膜牵引征5例(83.3%),毛刺征4例(66.7%)。结论:细支气管肺泡细胞癌影像表现复杂,充分认识细支气管肺泡细胞癌的各种征象能提高其影像诊断的准确率。

Objective:To study the imaging findings and pathology of bronchioalveolar carcinoma (BAC)to increase di-agnostic accuracy.Material s and Methods :The X-ray,CT and pathologic findings of 40cases of BAC were reviewed.Re sults:There were3types of BAC,in which21cases were of solitary nodule or mass type,13cases were of consolida-tion type,6cases were of the diffused nodular type.In the solitary nodule type,18nodules were located peripherally,3were located centrally.The main features in this type were pleural traction18cases(85.7%),vascular aggregated sign18cases(85.7%),spiculation16cases(76.2%),lobulation11cases(52.3%),air bronchogram11cases(52.3%),vacules5cases(23.8%).In consolidation type,single segmental?lobar consolidation were seen in6cases,multisegmental?lobar consolidation in7cases.The main features of this type were:air bronchogram9cases (100%),honeycomb sign8cases (88.9%),ground glass appearance4cases (44.4%),bulging of interlobar fissure3cases(33.3%),aggregation of vascular bundle3cases(33.3%).The main features of diffused nodular type were:various sizes of nodules were distributed asymetrically and in homogenerously in both lung fields,with nodular fus-ing in6cases,vacules within nodules4cases(66.7%),air bronchogram in fused nodules2cases(33.3%),vascular aggregated sign5cases (83.3%),pleural traction5cases (83.3%),spiculation4cases (66.7%).Con clu sions :The imaging features of bronchio-alveolar carcinoma were very com pli cated,mastering the imaging sign of BAC is very help ful to in crease di agnostic ac curacy.