MSCT对2cm以下周围型肺癌与炎性结节的诊断及鉴别

目的探讨2cm以下周围型肺癌与炎性结节在MSCT常规扫描与HRCT上征象的检出及表现,以提高诊断和鉴别诊断的准确性。方法收集了经病理和临床证实的2cm以下的73例周围型肺癌和32例炎性结节病例,分别采用7mm层厚和1mm HRCT重建,分析了病变密度、小泡征、支气管充气征、病灶边缘、分叶征、毛刺征、胸膜凹陷征、血管集束征、小棘突征、病灶周围模糊影及强化等征象表现。结果 7mm层厚像对肺癌与炎性结节征象检出比较P0.05,1mm HRCT对肺癌与炎性结节征象检出比较P0.05,1mm HRCT与7mm层厚像对肺癌征象检出比较P0.05,上述三者均有统计学意义,1mm HRCT与7mm层厚像对炎性结节征象检出比较P0.05,无统计学差异。小泡征、分叶征、毛刺征、胸膜凹陷征、血管集束征、小棘突征多见于肺癌。结论 1mm HRCT是周围型小肺癌与炎性结节鉴别的首选检查技术,尤其对小肺癌的诊断具有重要价值。

The Detection and Diagnosis of Peripheral Lung Cancer and Inflammation Nodules Signs Below 2cm During MSCT

Objective An approach to detection and signs of peripheral lung cancer and inflammation nodules below 2cm between MSCT conventional scanning and HRCT scanning, to improve the accuracy of the diagnosis and differential diagnosis. Methods 73 cases with peripheral lung cancer and 32 cases with inflammatory nodules under 2cm which were confirmed by pathology and clinical were collected, 7mm thick and 1mm thick HRCT were used respectively to scan, analyzing the density of lesions, bubble signs, air bronchograms, edge of lession, lobulation, spiculation,pleural indentation,small spines, fuzzy shadow around the lesions, and strengthen signs. Results Compared lung cancer signs with inflammation nodules signs, the detection of 7mm thick imaging is significant difference(P<0.05), the detection of 1mm thick HRCT signs betweem lung cancer and inflammation nodules is significant difference(P<0.05), compared 7mm thick imaging with 1mm thick imaging, the detection of lung cancer signs is significant difference(P<0.05), compared 7mm thick imaging with 1mm thick imaging ,the detection of inflammation nodules signs is without significant difference(P>0.05). Small spines, lobulation, spiculation,pleural indentation were often found in lung cancer. Conclusion 1mm thick HRCT scanning shoud be as a preferred check technology in differentiating peripheral small lung cancer and inflammation nodules, especially with important value for the diagnosis of small lung cancer.