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目的分析肺泡癌的临床诊断及胸部 CT 的影像学特征,提高肺泡癌的诊断水平。方法对1993至2003年间我院收治的1050例新发肺癌病例中经病理证实的50例肺泡癌的临床资料及1998至2005年中31例患者的高分辨率 CT 影像进行分析。结果 50例肺泡癌患者中,女30例,男20例,平均年龄为(58.4±10.7)岁。最常见的首发症状为咳嗽(20/50)。24例因肺部阴影而就诊的患者中20例无任何临床症状,多为早期结节型,病程最长4年。31例高分辨率 CT 检查的患者中8例为粟粒型,11例表现为结节型的患者中小泡征7例,钙化征7例;12例肺炎型患者中9例次出现低CT 值的实变影、假空洞征、网状影、磨玻璃影,2例出现碎石路征和 CT 血管造影征(增强扫描造影剂高峰时低密度的实变中血管影清晰可见)。结论肺泡癌仅占肺癌的4.76%(50/1 050)。肺泡癌尤其是结节型患者无临床症状者比例较高,且病程较长;定期行胸部 X 线检查很重要;胸部 CT 的特征性表现有助于诊断和鉴别诊断。
Objective To analyze the clinical diagnosis of pulmonary alveolar carcinoma and the imaging characteristics of chest CT to improve the diagnosis of alveolar carcinoma. Methods The clinical data of 50 cases of alveolar carcinoma confirmed by pathology from 1050 cases of newly diagnosed lung cancer admitted in our hospital from 1993 to 2003 and the high resolution CT images of 31 cases from 1998 to 2005 were analyzed. Results 50 cases of alveolar carcinoma patients, 30 females, 20 males, mean age (58.4 ± 10.7) years. The most common initial symptom is cough (20/50). Twenty-four patients were diagnosed with lung shadow without any clinical symptoms, mostly early nodules, with the longest duration of 4 years. Among the 31 high-resolution CT examinations, 8 were miliary, 11 were small nodules, and 7 were calcific. Among the 12 patients with pneumonia, 9 had low CT values Solidified shadow, false hole sign, reticular shadow, ground glass shadow, two cases of gravel road signs and CT angiography (enhanced scan contrast agent at low peak density of solidification in the blood vessels clearly visible). Conclusions Alveolar carcinoma accounts for only 4.76% (50/1 050) of lung cancer. Alveolar cancer, especially nodular patients with no clinical symptoms were higher, and longer duration; regular chest X-ray examination is very important; chest CT’s characteristic manifestations contribute to the diagnosis and differential diagnosis.