【摘要】 目的 探讨小细胞肺癌(SCLC)的CT影像学表现及淋巴结转移规律,从而提高对SCLC的诊断水平。方法 收集在本院就诊并经临床病理确诊为SCLC的102例病例的CT影像资料,分析中心型和周围型SCLC的CT影像学表现,采用卡方检验比较手术患者中心型和周围型SCLC淋巴结转移情况。结果 中心型SCLC 69例,周围型SCLC 33例;中心型SCLC表现为支气管壁增厚(54/69,78%),肺门肿块(25/69,36%)、病灶远端阻塞性改变(60/69,87%)以及淋巴结肿大(69/69,100%);周围型SCLC表现为孤立肿块,具有浅分叶(28/33,85%)、毛刺(12/33,36%)、血管集束(8/33,24%)、胸膜凹陷(12/33,36%)、空泡或细支气管充气征(7/33,21%)以及淋巴结肿大(31/33,94%)等特点。多数肿块密度均匀,中心型和周围型SCLC平扫CT值约(37±8.2)HU,增强扫描均呈较明显强化,强化后CT值增加(36±16.3) HU。中心型SCLC的淋巴结总转移率高于周围型SCLC(χ~2=29.273,P<0.05)。结论 SCLC的CT形态学表现具有一定特征性,中央型较周围型SCLC更易发生淋巴结转移,最终诊断依靠病理。更多还原

【Abstract】 Objective To determine computed tomography(CT) features and lymphnode metastatic regularity of small cell lung cancer(SCLC).Methods We retrospectively collected CT data of 102 patients with SCLC proved pathologically during January 2011to April 2012,Images were reviewed by two independent radiologists,and the CT features of central and peripheral SCLC were evaluated.χ~2-test was used to compare the lymphadenopathy characteristics of central and peripheral SCLC.Results Among the 102SCLC cases,69 cases were located centrally and 33 cases peripherally.The central SCLC were showed as following:bronchial wall thickening(54/69,78%),hilar mass(25/69,36%),obstructive changes(60/69,87%) and lymph nodes enlargement(69/69,100%).The peripheral SCLC were revealed as following:solitary masses or nodules with the lobulation(28/33,85%),speculation(12/33,36%),vascular cluster(8/33,24%),pleural retraction(12/33,36%),thin air bronchogram(7/33,21%) and lymph nodes enlargement(31/33,94%).Most of SCLC had homogeneous density(92/102,90%),which CT value was(37±8.2) HU on plain scan.There was marked enhancement on enhanced scan with enhanced CT value(36±16.3) HU.The total metastatic rates were higher in central type SCLC than that in peripheral type SCLC(χ~2=29.273,P<0.05).Conclusion There are some specific CT morphological features in SCLC,and lymphadenopathy is more common happened in central SCLC than that in peripheral SCLC.The final diagnosis of SCLC is depending on pathology.更多还原