MSCT在弥漫实变型肺泡癌与肺炎性实变鉴别诊断中的价值

目的:分析弥漫实变型肺泡癌(DCBAC)的多层螺旋CT影像表现及其病理基础,探讨与大叶性肺炎(LP)、干酪性肺炎(CP)的鉴别诊断。方法:回顾性总结分析12例经临床病理证实弥漫实变型肺泡癌的多层螺旋CT表现特征,并与同期证实的8例肺炎性实变病例的CT图像进行对照分析。结果:12例弥漫实变型肺泡癌在CT平扫出现"蜂窝征"(7例)、斑片状及腺泡样结节影(6例)、叶间裂膨隆(3例)。增强后病灶CT值均低于同层肌肉组织。动态观察肺实变范围扩大,原为腺泡结节和磨玻璃密度影的区域发展为肺实变。而在8例肺炎性实变中均未显示。结论:运用多层螺旋CT扫描技术可显著提高弥漫实变型肺泡癌与肺炎性实变的CT鉴别诊断能力。

Multi-slice CT The Diagnosis of Infiltration Consolidation Bronchioloalveolar Carcinoma and Differential Diagnosis with Pneumonia

Objective To study the multi-slice CT (MSCT) features and pathological basis of diffuse consolidation bronchioloalveolar carcinoma (DCBAC) in order to differentiate it from lobar pneumonia, cheesy pneumonia. Methods The MSCT data of 12 cases of (DCBAC) proved by clinical and pathology was retrospectively analyzed, and compared with the series data of 8cases of pneumonia. Results The 12 cases of (DCBAC) show "honeycomb sign" (n=7)、 alveolar node (n=6)、bulging of interlobar fissure (n=3). On dynamic observation, enlarging of pulmonary consolidation and merging of acinar nodules and/or ground-glass opacity into consolidation shadow could be seen. These characteristic signs were not shown on all pneumonia images. Conclusion With the application of multi-phases enhancement technique of MSCT, it is believed that the diagnosis and differential diagnosis of bronchioloalveolar carcinoma can be improved.