细支气管肺泡癌的CT诊断与误诊

目的 回顾性分析细支气管泡癌（ＢＡＣ）的ＣＴ表现的误诊原因，提高影像诊断准确率。材料与方法 ４２例经寅理证实的ＢＡＣ，根据ＣＴ表现分为结节型、实变型和多结节型，为２３．１６和３例，其中误诊１２例（２８．６％）。结合文献资料分析各型肺泡癌的ＣＴ征象。结果 结节型ＢＡＣ主要表现为：结节位于肺外围（９５．７％），有分叶（９１．３％）、毛刺（６９．６％）、空泡征或支气管气相（６５．２％）、密度不均（６５．

CT Findings and Misdiagnosis of Bronchioloalveolar Carcinoma

Objective To study the CT findings of bronchioloalveolar carcinoma (BAC), to analyze the causes of misdiagnosis and to increase the diagnostic accuracy.Materials and Methods 42 cases with pathologicallyproved BAC were divided into 3 types: (1) solitary nodule (n=23), (2) lobar consolidation (n=16) and (3) multinodular (n=3) type. 12 cases (28.6%)were misdiagnosed. CT features were analyzed with referring to the literatures.Results Solitary BAC demonstrated peripheral or subpleural in location (n=22), lobulated (n=21), spiculated (n=16), bubblelike lucency or air bronchogram sign (n=15), heterogeneous attenuations (n=15), pleural tag (n=14) and groundglass (n=12). Lobar consolidation BAC showed one lobar/segmental consolidation (6/16), or several lobar/segmental consolidations (10/16) accompanying with air bronchogram sign (14/16), cystic air spaces (13/16), groundglass shadow (7/16) and bulged interlobar fissure (6/16). Multinodular form was very rare, presented as diffuse nodules being located mainly in the middle and lower lung fields, some of them showing bubblelike lucency. The main cause for misdiagnosing was lack of adequate attention to and understanding of the disease.Conclusion To increase the diagnostic accuracy of BAC, it is essential to be familiar with its CT features and, in some circumstances, percutaneous thoracic biopsy or bronchoscopy is necessary.