高分辨率CT上非小细胞肺癌结节周围肺组织和血管改变的研究

A study on the pericancerous tissue and vascular changes in non-small cell lung cancer with high-resolution CT

目的 应用高分辨率CT(HRCT)对非小细胞肺癌 (NSCLC)结节周围组织、血管的改变进行研究 ,总结NSCLC的特征性改变 ,提高HRCT对NSCLC的诊断率。方法 应用HRCT观察 3 1例NSCLC和 12例肺部良性病变周围组织、血管的形态改变 ,由两位放射学家分别阅片 ,观察肺小叶血管支气管束、血管和叶间隔的改变。统计学处理应用 χ2 检验。结果 3 1例NSCLC患者中 ,2 0例 ( 64 .5 % )出现肺小叶支气管血管束增厚 ,15例 ( 4 8.4% )上级肺小叶动脉扩张 ,13例 ( 4 1.9% )上级肺小叶静脉扩张 ,16例 ( 5 1.6% )叶间隔增厚 ,5例 ( 16.1% )磨玻璃样变。对照组中肺小叶支气管血管束增厚者 2例 ( 16.7% ) ,上级肺小叶动脉扩张 1例 ( 8.3 % ) ,上级肺小叶静脉扩张 2例 ( 16.7% ) ,叶间隔增厚 6例 ( 5 0 .0 % ) ,5例 ( 4 1.7% )磨玻璃样变。NSCLC患者的肺小叶支气管血管束增厚和上级肺小叶动脉扩张的出现率均高于对照组 (P <0 .0 0 5和 0 .0 1<P <0 .0 2 5 )。结论 肺部结节伴肺小叶支气管血管束增厚或上级肺小叶动脉扩张时可高度怀疑NSCLC。

Objective To investigate the CT changes of pericancerous tissues with high resolution CT (HRCT) and to explore the specific signs of CT in non small cell lung cancer. Methods Thirty one patients with non small cell lung cancer and 12 patients with benign pulmonary nodules were analysed. An attention was paid on bronchovascular bundles, vessels and interlobular septa. HRCT films were read independently by two radiologists and results were statistically χ 2 tested.Results In the cancer group, 20 cases (64.5%) had thickening of bronchovascular bundles, 15 cases (48.4%) angiectasis of superior lobular arteries, 13 cases (41.9%) angiectasis of superior lobular veins, 16 cases (51.6%) thickening of interlobular septa, and 5 cases (16.1%) ground glass opacity. In benign pulmonary lesion group, the values were 2 (16.7%) , 1 (8.3%), 2 (16.7%), 6 ( 50.0% ) and 5 (41.7%) cases respectively. Significant differences were found between the two groups in the thickening of bronchovascular bundles and the angiectasis of superior lobular arteries.Conclusion Thickening of bronchovascular bundles and angiectasis of superior lobular arteries are the specific signs of non small cell lung cancer.