间质纤维化背景下肺癌的CT征象及动态演变特征

发布时间：2018-03-24 03:04

本文选题：肺肿瘤　切入点：肺纤维化　出处：《中国临床医学影像杂志》2017年06期

【摘要】：目的 :通过回顾性分析发生在蜂窝肺背景下的一组肺癌病例的CT表现,期望提高对肺间质纤维化合并肺癌的重视,提高诊断能力。方法:回顾性收集我院2011年11月—2016年7月5年内蜂窝肺合并肺癌的病例,采用西门子双源CT(Somatom Definition Flash)和西门子128层CT(Somatom Definition AS)进行扫描,仰卧位,扫描层厚5 mm,重建图像层厚1 mm(高分辨算法重建)。采用统一图像观察窗位,测量记录病变的大小、位置、形态学征象及CT复查的动态变化特征。结果:共收集间质纤维化背景下发生肺癌的病例36例,所有病例均经手术病理或穿刺活检病理证实为肺癌,其中腺癌11例(30.6%),鳞癌25例(69.4%)。临床诊断为特发性肺间质纤维化2例,慢性阻塞性肺疾病(COPD)12例,类风湿关节炎6例,系统性红斑狼疮8例,干燥综合征3例,皮肌炎3例,成人Still病2例。根据CT表现将本组肺癌分为4种类型:(1)结节型,26例(72.20%);(2)不规则实变型,4例(11.1%);(3)不规则索条型,2例(5.6%);(4)三角形或楔形实变型,4例(11.1%)。36例患者中20例初次CT检查时诊断为肺癌,诊断正确率55.56%。结论:间质纤维化背景下合并肺癌的CT表现多样,尤其是肺纤维化区内的结节及片状实变影应予以动态观察。
[Abstract]:Objective: through the retrospective analysis of CT manifestation in the background of a group of honeycombing lung cancer, expected to improve pulmonary interstitial fibrosis of lung cancer complicated with attention, improve the diagnosis ability. Methods: We retrospectively collected in our hospital from November 2011 to July 2016 5 years honeycombing combined with lung cancer patients, using the SIEMENS dual source CT (Somatom Definition Flash) and SIEMENS (Somatom Definition 128 CT AS) scan, supine, slice thickness 5 mm, reconstruction thickness of 1 mm (high resolution reconstruction algorithm). Using a unified image observation window, measure and record the lesion size, location, dynamic characteristics and morphological features of CT were. Lung cancer: interstitial fibrosis were collected under the background of 36 cases, all cases were confirmed by surgical pathology or biopsy for lung cancer, including 11 cases of adenocarcinoma (30.6%), 25 cases of squamous cell carcinoma (69.4%). The clinical diagnosis of idiopathic 2 cases of pulmonary interstitial fibrosis, chronic obstructive pulmonary disease (COPD) in 12 cases, 6 cases of rheumatoid arthritis, 8 cases of systemic lupus erythematosus, Sjogren syndrome 3 cases, 3 cases of dermatomyositis, 2 cases of adult Still disease. According to the CT findings of the group of lung cancer are divided into 4 types: (1) nodules type, 26 cases (72.20%); (2) irregular consolidation, 4 cases (11.1%); (3) irregular bands, 2 cases (5.6%); (4) a triangular or wedge-shaped consolidation, 4 cases (11.1%) of.36 patients in 20 cases of primary CT diagnosis for lung cancer the correct diagnosis rate of 55.56%.. Conclusion: CT findings of interstitial fibrosis associated with lung cancer under the background of diversity, especially nodules and patchy pulmonary fibrosis within the area of consolidation should be observed.

【作者单位】：山西大医院CT室;
【分类号】：R730.44;R734.2

【相似文献】