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目的 :探讨MRI点簇状高信号对不同组织类型肺癌的鉴别诊断意义及其病理基础。材料和方法 :经病理证实的周围型肺癌58例。应用Disonics0.35T超导成像系统 ,以10mm层厚行横断面T1WI、T2WI及冠状面T1WI成像 ,观察肿块内点簇状高信号的出现率 ,并与手术及病理对照。结果 :24例在T2WI图像上于较均匀的肿瘤实质内部见到簇状分布的圆点状高信号区。鳞癌发生率14.3 %(3/21) ,腺癌60.7 %(17/28) ;未分化癌、肺泡细胞癌及鳞腺混合癌4例(病例较少无法统计)。腺癌、鳞癌间差别显著。35例手术病例鳞癌质地较硬 ,腺癌较软 ;出现点簇状信号的12例 ,9例为腺癌 ,标本切面均未见明显坏死 ,镜下可见丰富的腺腔。统计学结果表明T2WI上点簇状高信号的出现与腺癌腺腔丰富密切相关。结论 :T2 加权上点簇状高信号的出现提示腺癌的可能性较大。
Objective: To investigate the differential diagnosis significance and pathological basis of MRI cluster-like high signal on different types of lung cancer. Materials and Methods: 58 cases of peripheral lung cancer confirmed by pathology. The Disonics0.35T superconducting imaging system was used to observe the incidence of clustered hyperintense spots in the tumor with 10mm slice thickness T1WI, T2WI and coronal T1WI imaging. The imaging results were compared with the surgical and pathological findings. Results: Twenty-four cases showed clustered dot-like high signal region in the more homogeneous tumor parenchyma on T2WI images. The incidence of squamous cell carcinoma was 14.3% (3/21) and adenocarcinoma was 60.7% (17/28). There were 4 cases of undifferentiated carcinoma, alveolar cell carcinoma and mixed adenocarcinoma of the squamous cell carcinoma. Adenocarcinoma, squamous cell carcinoma between the significant difference. In 35 cases of squamous cell carcinoma, the squamous carcinoma was harder and the adenocarcinoma was softer. There were 12 cases of clustered signals and 9 cases of adenocarcinoma. No necrosis was observed in the section of the specimen, and abundant glandular cavity was observed in the microscope. Statistical results show that the appearance of dotted hyperintense signal on T2WI is closely related to the glandular glandular cavity richness in adenocarcinoma. Conclusion: The appearance of cluster-like high signal on T2 weighted point is more likely to suggest adenocarcinoma.