原发周围型小肺癌影像分析及其动态观察
小肺癌,,周围型小肺癌；诊断；体层摄影术，X线计算机,1资料与方法,2结果,3讨论,【参考文献】
【摘要】 目的 探讨传统X线胸片及胸部CT平扫和动态增强在诊断原发周围型小肺癌的临床价值。方法 回顾性分析6年来经手术和穿刺活检等病理证实，有完整资料的12例原发周围型小肺癌。所有患者通过传统X线筛选后做常规CT平扫(层厚层距10mm)，同时在病灶区薄层扫描(层厚层距1～2mm)或HRCT及动态增强并分析影像特征。结果 12例中腺癌6例，鳞癌4例，大细胞癌1例,腺鳞癌1例。分叶征(6/12)，毛刺征(8/12)，空泡征(3/12)，血管纠集征(4/12)，胸膜凹陷征(5/12)。病变均位于肺外围。12例做了增强扫描，病灶呈中度增强，CT值增幅为20～60HU。结论 采用传统X线胸片及CT薄扫动态增强，结合CT导向下穿刺活检，对提高诊断原发周围型肺癌的认识和定性诊断十分重要，明显缩短临床观察时间，提高诊断及时性，为选择治疗方法和预后提供有意义的指导价值，有利于提高患者的存活率和生存质量。【关键词】 周围型小肺癌；诊断；体层摄影术，X线计算机
Imageologic analysis and dynamic observation of primary small peripheral lung cancer
HAN Guo-wu.Department of Radiology,Xingshan Medical Centre,Xingshan 443711，China
【Abstract】 Objective To explore the clinical value of diagnosis original small peripheral lung cancer referring to conventional chest film as well as thoracic CT scan and dynamic enhanced.Methods Retrospective analysis on 12 cases of original small peripheral lung cancer with complete data during last 6 years,which were pathologically confirmed by operations and biopsies was performed.All patients screened by conventional X-ray underwent conventional plain CT scan (with 10mm collimation thickness),thin slice scan or HRCT of the focus zone (with 1～2mm collimation thickness) and dynamic enhanced.Image analysis was carefully made.Results Amongst these 12 cases,there were 6 adenocarcinomas,4 squamous cell carcinomas,1 large cell carcinoma and 1 adenosquamous carcinoma.We have found lobulation(6/12),spiculation(8/12),air bronchograms (3/12),convergence of peripheral vessels(4/12)and pleural indentation(5/12).All the pathological changes appeared on the periphery of lung.Enhanced scanning in these 12 cases showed that the foci were moderate enhanced and the amplitude of CT value were 20～60HU.Conclusion It is of great importance for better understand and qualitative diagnosis of original small peripheral lung cancer to use conventional X-ray chest film,thoracic CT scan and dynamic enhanced,and needle biopsy conducted by CT.The period of clinical observation can be notably shortened and the diagnosis can be timely made.It is also helpful to select therapeutic methods,estimate prognosis and improve the patients survival and the quality of life. ......
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