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目的探讨支气管肺泡癌CT诊断及鉴别诊断的意义。方法回顾性分析本院经手术或穿刺活检病理证实的23例支气管肺泡癌,其中男性13例,女性10例,年龄42-69岁,平均年龄53岁。均行螺旋CT扫描,其中18例为HRCT扫描。结果在12例结节病例中,均为单发结节。边缘呈分叶征8例,毛刺征6例,胸膜凹陷征7例,空泡征6例,磨玻璃密度5例。在8例炎症型病例中,病灶呈多发的实变表现;“枯树枝征”3例,“铺路石征”3例,蜂窝样改变2例。在3例弥漫型病例中,病灶呈广泛分布,且大小不均匀。结论细支气管肺泡癌影像表现多样,诊断复杂,需结合病史综合分析,才能提高诊断的准确率。
Objective To investigate the significance of CT diagnosis and differential diagnosis of bronchoalveolar carcinoma. Methods A retrospective analysis of 23 cases of bronchoalveolar carcinoma confirmed by surgery or biopsy in our hospital, including 13 males and 10 females, aged from 42 to 69 years with a mean age of 53 years. All patients underwent spiral CT scan, of which 18 were HRCT scans. Results in 12 cases of nodules were single nodules. The edge of lobular sign in 8 cases, burr sign in 6 cases, pleural indent sign in 7 cases, vacuole sign in 6 cases, ground glass density in 5 cases. In 8 cases of inflammatory disease, the lesions showed multiple consolidation; 3 cases of “dead branches sign”, 3 cases of “paving stone sign” and 2 cases of honeycomb-like changes. In 3 cases of diffuse cases, lesions were widely distributed, and the size is not uniform. Conclusions Bronchial alveolar carcinoma images are diverse and complicated to diagnose. Combined with the comprehensive analysis of medical history, the diagnostic accuracy can be improved.