论文部分内容阅读
目的:回顾性分析肺癌的不典型CT表现,旨在提高CT诊断准确率。方法:41例经病理证实的肺癌,根据CT表现分为结节型(24例)、实变型(15例)和多结节型(2例)。采用常规CT平扫和增强扫描,层厚、层距5mm～10mm。结果:结节型主要表现:结节位于肺外围或胸膜下(22例)、具有浅分叶(10例)、形状不规则(6例)、边界光滑(8例)、长毛刺(4例)、密度不均匀(8例)、小空洞(2例)、钙化(2例)、与胸膜广泛接触(2例)和卫星灶(5例);实变型可为单叶或段实变(7例)、多叶或段实变(8例)、具有支气管充气相(12例)、毛玻璃样影(3例)和胸膜改变(4例);多结节型较少,共2例,表现为一侧或两侧肺野弥漫分布细小结节影。病理证实为腺癌(26例)、细支气管肺泡癌(8例)、鳞癌(4例)、小细胞未分化癌(2例)和类癌(1例)。CT误诊为炎症(32例)、结核(9例)。结论:误诊主要原因是缺乏典型的CT表现。因此熟悉和了解各种不典型CT表现,必要时结合活检,方能提高CT诊断准确率,减少误诊。
Objective: To retrospectively analyze the atypical CT features of lung cancer and to improve the diagnostic accuracy of CT. Methods: Totally 41 cases of pathologically confirmed lung cancer were divided into nodular (24 cases), real (15 cases) and multiple nodular (2 cases) cases according to CT findings. Using conventional CT scan and enhanced scan, layer thickness, layer spacing 5mm ~ 10mm. Results: The nodules were mainly located in the peripheral or subpleural of the lung (22 cases), with shallow lobes (10 cases), irregular shape (6 cases), smooth border (8 cases), long burr (4 cases (8 cases), small cavity (2 cases), calcification (2 cases), extensive contact with pleura (2 cases) and satellite lesions (5 cases). The consolidation type could be single leaf or segment consolidation 7 cases), multilobed or segment consolidation (8 cases), with bronchial gasification phase (12 cases), ground glass sample (3 cases) and pleural changes (4 cases) The performance of one or both sides of the lung field diffuse distribution of small nodules. Pathological findings were adenocarcinoma (26 cases), bronchioloalveolar carcinoma (8 cases), squamous cell carcinoma (4 cases), small cell undifferentiated carcinoma (2 case) and carcinoid (1 case). CT misdiagnosed as inflammation (32 cases), tuberculosis (9 cases). Conclusion: The main reason for misdiagnosis is the lack of typical CT findings. Therefore, familiar with and understand a variety of atypical CT manifestations, if necessary, combined with biopsy, CT diagnostic accuracy can only improve and reduce misdiagnosis.