| 李琦,罗天友,黄兴涛,吴景全.临床Ⅰ期中央型肺癌CT继发征象及其演变规律[J].中国医学影像技术,2016,32(12):1876~1880 |
| 临床Ⅰ期中央型肺癌CT继发征象及其演变规律 |
| Secondary CT signs and their evolution rules of clinical stage Ⅰ central lung cancer |
| 投稿时间：2016-04-28 修订日期：2016-10-27 |
| DOI：10.13929/j.1003-3289.2016.12.022 |
| 中文关键词: 肺肿瘤 继发征象 支气管黏液嵌塞 体层摄影术,X线计算机 |
| 英文关键词:Lung neoplasms Secondary signs Bronchial mucoid impaction Tomography, X-ray computed |
| 基金项目:临床重点专科建设项目（国卫办医涵2013544号）。 |
|
| 摘要点击次数: 2051 |
| 全文下载次数: 1117 |
| 中文摘要: |
| 目的 探讨临床Ⅰ期中央型肺癌的CT继发征象及其演变规律。方法 回顾性分析48例经病理证实的临床Ⅰ期中央型肺癌患者的CT资料。病理确诊前37例接受1次CT检查，11例接受2~3次CT检查。结果 48例中，41例（41/48，85.42%）出现1种或多种继发征象，包括段以远支气管黏液嵌塞（BMI）38例（38/48，79.17%）、阻塞性肺炎（OP）20例（20/48，41.67%）、阻塞性肺气肿（OE）7例（7/48，14.58%）、阻塞性肺不张（OA）5例（5/48，10.42%）。肿瘤最大径<3 cm与3~5 cm患者间继发征象BMI、OE及OP的发生率差异均无统计学意义（P均>0.05），但肿瘤最大径3~5 cm患者OA的发生率高于肿瘤最大径<3 cm患者（P<0.05）。11例接受多次CT检查的患者中，7例首次CT检查时出现继发征象，早期继发征象均为BMI，其中4例伴有OP和（或）OE，随病情进展，OE消失，BMI及OP持续存在且较前加重；7例中，4例继发OA。11例中，首次检查时CT漏诊7例，误诊4例；6例至确诊时TNM分期已发生变化。结论 段以远BMI为Ⅰ期中央型肺癌最常见的早期继发征象，正确识别这些继发征象，掌握其演变规律，有助于中央型肺癌的早期诊断。 |
| 英文摘要: |
| Objective To explore secondary CT signs and their evolution rules of clinical stage I central lung cancer. Methods CT data of 48 patients with clinical stage I central lung cancer confirmed by pathology were retrospectively analyzed. Among them, 37 cases underwent one time CT scanning and another 11 cases underwent two or three times CT examinations before pathological diagnosis. Results In 48 cases, 41 cases (41/48, 85.42%) had one or more secondary CT signs, including 38 cases (38/48, 79.17%) of bronchial mucoid impaction (BMI) distal to the segmental bronchus, 20 cases (20/48, 41.67%) of obstructive pneumonia (OP), 7 cases (7/48, 14.58%) of obstructive emphysema (OE) and 5 cases (5/48, 10.42%) of obstructive atelectasis (OA). There was no significant differences of the incidence of BMI, OE and OP between patients with maximum tumor size <3 cm and 3-5 cm (all P>0.05). While the incidence of OA in patients with maximum tumor size 3-5 cm was higher than that in patients with maximum tumor size <3 cm (P<0.05). In 11 cases with multiple CT examinations, 7 cases appeared secondary signs in the initial CT examination and the early secondary signs in all of them included BMI. And 4 of 7 cases with BMI were accompanied by OP and/or OE. As the enlargement of tumor size, OE disappeared, while BMI and OP continued to exist and became more serious than before. Among the 7 cases, OA appeared in 4 cases. In 11 cases, 7 cases were missed and 4 cases were misdiagnosed by the first CT examination, and the TNM staging has changed in 6 cases at the time that the diagnosis was confirmed. Conclusion BMI distal to the segment bronchus is the most common early secondary CT sign of stage Ⅰ central lung cancer. Correctly identify these secondary signs and grasp their evolution rules are helpful for the early diagnosis of central lung cancer. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
