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目的 :探讨肺鳞癌、肺腺癌的CT鉴别要点。方法 :对 51例肺鳞癌及 4 3例肺腺癌的CT表现进行回顾性分析。结果 :鳞癌 70 6%为中央型 ,2 9 4 %为周围型 ;腺癌 4 7%为中央型 ,95 3%为周围型。 15例周围型肺鳞癌均表现为肿块 ,而 4 1例周围型肺腺癌中 ,5例为局灶性实变 ,3例为两肺弥漫性实变与结节。在周围型肺癌中 ,肺腺癌肿块的毛刺征、胸膜凹陷征、小泡征及早期远处转移多见 ,三级支气管受累少见 ;而鳞癌的三级支气管受累征、局灶性坏死、瘤周肺野改变明显 ,毛刺征、小泡征及胸膜凹陷征少见。肺腺癌、鳞癌肿块内均可见小钙化灶。在中央型肺癌均表现为支气管壁增厚、管腔变窄及远方阻塞性肺部改变 ,但腺癌少见 ,而鳞癌多见且有多枝蔓延的趋势。结论 :胸部CT观察肺癌的征象较确切 ,但在影像学判断肺癌组织学类型方面较常规X线胸片未见明显突破。
Objective: To investigate the key points of CT in the diagnosis of lung squamous cell carcinoma and lung adenocarcinoma. Methods: The CT findings of 51 cases of lung squamous cell carcinoma and 43 cases of lung adenocarcinoma were analyzed retrospectively. Results: 70.6% of squamous cell carcinomas were of central type, 294% of them were peripheral ones, 47% of adenocarcinomas were central ones and 95.3% of them were peripheral ones. In 15 cases of peripheral squamous cell carcinoma, all showed lumps, while in 41 cases of peripheral adenocarcinoma, 5 cases were focal consolidation and 3 cases were diffuse consolidation and nodules of both lungs. In the peripheral type of lung cancer, the sporadic lung adenocarcinoma, pleural indentation, vesicular signs and early distant metastasis more common, three bronchial involvement rare; and squamous cell carcinoma of the tertiary bronchial involvement syndrome, focal necrosis, Perinatal lung field changes significantly, burr levy, vesicular levy and pleural indent sign rare. Lung adenocarcinoma, squamous cell carcinoma are visible within the small calcification. In the central lung cancer showed bronchial wall thickening, lumen narrowing and distal obstructive pulmonary changes, but rare adenocarcinoma, and squamous cell carcinoma more common and more branches of the trend of spread. Conclusion: The signs of lung cancer in chest CT are more exact, but there is no obvious breakthrough in radiological diagnosis of histological types of lung cancer.