含气支气管征在CT诊断周围型小肺癌的价值

目的:探讨周围型小肺癌内含气支气管的病理基础、CT表现及其诊断价值。方法:回顾性分析经手术病理证实的46例周围型小肺癌(直径≤3 cm)及22例孤立性良性结节含气支气管征的薄层CT表现,其中腺癌31 例,细支气管肺泡癌6例,鳞癌5例,腺鳞癌3例,小细胞癌1例。结果:46 例肺癌中,CT上显示含气支气管征20 例(43.5%),其中腺癌显示含气支气管征17例、肺泡癌2例、鳞癌1例,其他类型的肺癌未见此征。病灶内含气支气管影形态改变主要表现为管腔不规则狭窄、扭曲、扩张与中断。22例良性结节中,CT显示含气支气管征1例,其影像表现为管腔通畅,形态无明显异常。结论:孤立性肺结节内含气支气管征的出现,特别是形态学改变对周围型小肺癌的诊断具有重要的临床价值。

Value of Air Bronchogram Sign on CT in Diagnosis of Small Peripheral Lung Cancers

Objective:To study the pathology,the CT signs and the diagnostic value of the air bronchogram sign in small peripheral lung cancers.Methods:Forty-six patients with small peripheral lung cancer and twenty-two with solitary benign nodule undergone chest CT scans and with histological diagnosis were studied retrospectively.Results:Of 46 lung cancers,20 cases (43.5%) had air bronchogram.The frequency of this sign in various types of lung cancer was as follows:adenocarcinoma 17 of 31(54.8%);alveolar carcinoma 2 of 6; squamous cell carcinoma 1 of 5. This sign was not seen in other types of lung cancer.In these cases the bronchi mainly exhibited four morphologic patterns:irregular stenosis,tortuo- sity, ectasia and cut-off.Of 22 cases of benign lesions,only 1 (4.5%) had air bronchogram sign and the morphology of the bronchus was normal.Conclusion:The CT air bronchogram sign in solitary pulmonary nodules (SPN),especially the morphologic changes have important diagnostic values for evaluation of small peripheral lung cancer.