摘要
目的 探讨细支气管肺泡癌 (BAC)的高分辨率CT征象。方法 对 2 9例BAC进行回顾性分析。分别记录结节型、多发结节型和实变型BAC的HRCT征象 ,分析有助于诊断的征象及病理基础。结果 14例结节型病灶中 86%位于肺野外周或胸膜下 ,43 %呈不规则形 ,空泡征出现率 5 1% ,磨玻璃密度 3 6% ,胸膜尾征 71% ;多发结节型的单个病灶与前者相同 ;11例实变型中磨玻璃密度、多发结节和段叶实变混合存在的 6例 ,肺段实变周围或其他肺野分布的磨玻璃密度影内伴随网格影 ,其中 1例呈“碎石路样”。结论 ①周围性结节以及伴空泡征、磨玻璃密度、胸膜尾征 4项中有 3项者高度提示结节型BAC的诊断 ;②肺段叶“蜂房样”实变并其他肺野的“碎石路样”影对弥漫性细支气管肺泡癌 (DBAC)的诊断具有特征性。③HRCT是BAC早期诊断的重要手段之一。
Objective To study the appearance of bronchioloalveolar carcinoma (BAC) on high resolution CT (HRCT) scans, and to determine the signs of suggestion of this diagnosis. Methods HRCT scans of 29 patients with pathologically proven BAC of the lung were retrospectively reviewed. HRCT findings were separately recorded into 3 types (solitary nodule, multi nodular, consolidation type) and were assessed with the pathologic correlation. Results CT findings of solitary nodule ( n =14) included peripheral distribution,irregular shape,bubble like attenuation,ground glass opacity,pleural tails. The features of single lesion in multi nodular ( n =4) were the same as the former. According to consolidation ( n =11), 6 patients had coexisting nodules and 6 had associated ground glass opacities. One of them had a pattern of ground glass opacities with thickened interlobular fissures similar to the CT 'crazy paving' pattern around the segment of the consolidation. Conclusion ①If three signs were shown on HRCT among the nodule peripheral distribution, bubble like attenuation, ground glass opacity and pleural tails, it should be diagnosed as solitary nodular BAC. ②The lobar or segmental heterogeneous consolidation associated the CT 'crazy paving' pattern should suggest a diagnosis of DBAC. ③HRCT is an important way to determine the early diagnosis of BAC.
出处
《中国医学影像技术》
CSCD
2002年第12期1250-1252,共3页
Chinese Journal of Medical Imaging Technology
