临床I期周围型肺癌的MDCT特征及误诊原因分析

目的：探讨临床I期周围型肺癌的MDCT特征并分析误诊情况及鉴别要点。方法收集我院2010年5月至2015年11月期间收治的周围型肺癌患者82例进行回顾性分析，应用GE Light Speed VCT 64排CT扫描机进行CT检查，统计患者病灶形态、瘤肺界面、边缘形态、内部结构及邻近结构改变，总结I期周围型肺癌的MDCT典型征象。结果 I期周围型肺癌的T1a期、T1b期、T2a期患者均以圆/类圆形为主、边界多清晰，部分可见空泡征、支气管截断胸膜凹陷与血管集束征。T1a期、T1b期多见分叶与毛刺，少见棘状突起，T2a期患者均可见分叶，少见毛刺与棘状突起。结论 I期周围型肺癌的MDCT具有明显特征性，利于定位及定性诊断。此外，I期周围型肺癌易被误诊为结核球、球形肺炎、炎性假瘤、错构瘤，为提高临床检出率，需把握鉴别诊断要点。

MDCT Features of Peripheral Lung Cancer in Patients with Clinical Stage I and Analysis of the Causes of Misdiagnosis

Objective To investigate the MDCT features of peripheral lung cancer in patients with stage I and analyze the misdiagnosis and differential diagnosis.Methods In our hospital in 2010 may to November 2015 admitted during the period of peripheral lung cancer patients 82 cases were retrospectively analyzed. Application of Ge light speed VCT 64 slice CT scanner of CT examination, statistical lesion morphology, tumor lung interface, edge shape, internal structure and adjacent structures change, summary of stage I lung cancer peripheral MDCT typical signs.Results The T1a phase, T1b phase and T2a phase of I stage lung cancer were all round/round/round, with clear boundary, partially visible vacuole sign, and the truncated pleural indentation and vascular bundle sign. T1a phase, T1b phase and the burr, a rare spike, T2a patients are visible in the sub leaf, a rare spike and spike like.Conclusion MDCT of peripheral lung cancer in I stage has obvious characteristics, which is beneficial to the location and qualitative diagnosis. In addition, phase I of peripheral lung cancer easily misdiagnosed as tuberculoma, spherical pneumonia, inflammatory pseudotumor, hamartoma, in order to improve the detection rate of clinical, need to grasp the main points of differential diagnosis.