【摘要】 目的:探讨恶性孤立性肺结节(SPN)的螺旋CT表现。方法:回顾性分析100例经手术病理或随访证实为肺癌且影像资料齐全的孤立性肺结节。CT资料着重观察:病灶的形态、边缘征象、内部征象、邻近结构改变及强化特性,并比较各病理类型的特征表现及随访变化。结果:100例恶性SPN中病灶呈类圆形占96%;边缘清楚占95%;分叶或脐凹征显示率达74%;毛刺占76%(长毛刺:19%,短毛刺:65%;二者同时存在8%);棘状突起占26%;含气支气管征占20%;空泡征达13%;空洞占13%(均为不规则厚壁、偏心空洞);血管纠集征占23%;胸膜凹陷征占43%;局限胸膜黏连、增厚占16%。细支气管肺泡癌(Bronchioloalveolarcarcinoma,BAC)空泡征、含气支气管征、晕征显示率高于非细支气管肺癌(NBAC)(P<0.05)。鳞癌空洞显示率高于其他恶性结节(P<0.05)。鳞癌增强后,不均匀强化率比非鳞癌结节不均匀强化率高(P<0.05)。结论:在螺旋CT扫描中,恶性孤立性肺结节可出现多种征象,其中分叶征和毛刺征的诊断价值较高。根据结节的各种征象和强化方式,结合各种CT检查技术有助于病变的定性诊断。更多还原

【Abstract】 Objective:To explore and discuss the CT manifestations of malignant solitary pulmonary nodules(SPNs).Methods: CT images of 100 malignant SPN cases proved by surgery or follow-up were retrospectively studied.Imaging study was focused on the configuration,margin,internal characteristics,enhancement pattern and adjacent involvement of the nodules.Attentions were paid to differentiations among different pathological types of SPNs.Results: CT appearances in malignant SPN were as follows: round or oval was 96%;well defined margin 95%;lobulation 74%;speculation 76%(coarse speculation 19%,fine speculation 65%,with both 8%);spinous protuberance 26%;air bronchogram 20%;bublle-like areas 13%;cavity 13(%all were irregular thick-walled and eccentric);bronchovascular convergence 23%;pleural tag 43%;localized pleural adhesion and thicken 16%.BACs had more CT signs than NBACs such as bulble-like air,bronchogram and halo.Cavity,spinous protuberance and inhomogeneous enhancement were more common in the squamous cell carcinoma than that of other types of malignant SPNs(P<0.05) Conclusion: Malignant SPNs demonstrate abundant CT features in which lobulation and speculation have high diagnostic values.Combined with CT signs,enhancement pattern and advanced techniques facilitate to establish preoperational diagnosis.更多还原