弥漫性细支气管肺泡癌的CT表现

目的探讨弥漫性细支气管肺泡癌的CT表现特征，并确定弥漫性细支气管肺泡癌与肺结核鉴别诊断的一些有益表现。方法对经病理证实的25例弥漫性细支气管肺泡癌患者的cT表现进行回顾性分析，并将CT结果与粟粒性肺结核、支气管结核进行对比。结果弥漫性细支气管肺泡癌CT表现包括磨玻璃样变、实变、结节、小叶中心结节、周边分布、空气支气管征和肺下叶为主。根据主要特征，弥漫性细支气管肺泡癌的CT表现可以分为：磨玻璃样变为主、实变为主和多发结节为主的三种类型。大多数弥漫性细支气管肺泡癌患者为这些表现的混合。弥漫性细支气管肺泡癌CT表现与肺结核差别不大，但结节分布的主要区域和磨玻璃样变的区域是不同的，弥漫性细支气管肺泡癌的结节多位于小叶中心，实变为主的弥漫性细支气管肺泡癌和支气管结核的差异主要在于是否存在远离实变的磨玻璃样变和肺下叶分布。结论弥漫性细支气管肺泡癌的CT表现不是特定的，但实变和结节的混合、中心小叶结节的共存、边缘区域的磨玻璃样变及肺下叶分布优势应是弥漫性细支气管肺泡癌的较为特征性的表现。

CT findings of diffuse bronchioloalveolar carcinoma

Objective To analyze the CT features of diffuse bronchioloalveolar carcinoma and determine the useful findings in differential diagnosis of bronchioloalveolar carcinoma and tuberculosis. Methods CT scans of 25 patients with pathologically proven diffuse bronchioloalveolar carcinoma were reviewed. The CT findings were compared with those of miliary tuberculosis and bronchagenic tuberculosis. Results CT findings of diffuse bronchioloalveolar carcinoma included ground-glass opacity, consolidation, nodules, eentrilobular nodules, peripheral distribution, air bronchogram, lower lung predominance. According to the major features, CT findings of diffuse bronchioloalveolar carcinoma could be classified into three patterns： predominantly ground-glass,consolidative,a nd multinodular. Most patients with diffuse bronchioloalveolar carcinoma had a mixture of these findings. The frequency of findings of diffuse bronchioloalveolar carcinoma on CT was not different from that of tuberculosis, but the predominant distribution of the nodules and areas of ground-glass attenuation differed between the two. The distribution of nodules in diffuse bronchioloalveolar carcinoma was pedominantly centrilobular; Differences in distribution between diffuse bronchioloalveolar carcinoma and bronchogenic tuberculosis included ground-glass opacity remote from consolidation and a lower lung predominance. Conclusion Although these CT findings are not specific, the combination of consolidation and nodules, the coexistence of centrilobular nodules, remote areas of ground-glass attenuation, and lower lung predominance are more characteristic of diffuse bronchioloalveolar carcinoma.