孤立性肺转移瘤的CT诊断

目的　探讨孤立性肺转移瘤 (SPM)的CT表现 ,以提高对SPM的CT诊断水平。方法　对 2 1例经病理证实的SPM的CT表现进行回顾性分析。结果　①病灶分布 :2 1例SPM中位于左肺 10例 (4 7.6% ) ,右肺 11例 (5 2 .4% ) ;双肺上叶 (不含左上叶舌段 )3例 (14 .3 % ) ,右中叶及左上叶舌段 5例 (2 3 .8% ) ,双肺下叶 13例 (61.9% ) ;位于肺野外 1/ 3带者 14例 (66.7% ) ,中 1/ 3者5例 (2 3 .8% ) ,内 1/ 3者 2例 (9.5 % )。②大小 :<3cm者 17例 (81.0 % ) ,>3cm者 4例 (19.0 % )。③形态、边缘 :15例 (71.4% )呈圆形或椭圆形且表面光滑 ,界面清楚 ,6例 (2 8.6% )呈不规则形并分别或同时见分叶征 (3例 )、毛刺征 (2例 )、胸膜凹陷征、血管集束征、晕环征 (各 1例 )。④密度 :病灶呈均匀软组织密度 16例 (76.2 % ) ,内见钙化灶 2例 ,空洞 1例 ,低密度坏死区 2例。⑤本组病例均未见SPM侵犯临近支气管。结论　SPM的CT表现具有一些特点 ,但其诊断与鉴别诊断需CT表现紧密结合临床和病理才能得出正确结论。

CT Diagnosis of Solitary Pulmonary Metastases

Objective To explore the CT appearances of solitary pulmonary metastases(SPM)in order to improve the level of CT diagnosis of SPM.Methods The CT findings of 21 cases with SPM proved by pathology were analyzed retrospectively . Results 1.The distribution of lesions:in 21 cases with SPM were:10 ( 47.6% ) niduses in left lung , 11 ( 52.4% ) lung in right ;3 (14.3% ) in bilateral superior lobuses ( excluding segmentum lingulare ),5 ( 23.8% ) in lobus medius and segmentum lingulare,13 ( 61.9% ) in inferior lobuses;14(66.7%)in external 1/3 of lung field,5(23.8%)in middle 1/3 and 2(9.5%)in interior1/3; 2.The diameter of lesions were:d<3 cm(17cases,81.0%),d>3 cm(4,19.0%). 3.The shape and the margin of lesions were:circular or ellipse niduses with smooth surface and clear tumor-lung interface in 15 ( 71.4% ) ,irregular-shaped niduses in 6 ( 28.6% ) , with lobulation sign in 3 , spiculae in 2 , pleural indentation,bronchovascular bundles and halo in 1 respectively ; 4.The density of lesions were:Uniform soft tissular density in 16 cases(76.2%),calcification in 2,cavity in 1 and necrotic area in 2; 5.In all 21 cases,it was not found that SPM invaded bronchi nearby .Conclusion SPM has some certain characterizes on CT,but only by combining CT appearances with clinic and pathology,its correct diagnosis can be done.