周围型小细胞肺癌的CT征象分析

目的 探讨周围型小细胞肺癌(SCLC)的CT征象.方法 回顾分析78例经病理证实的周围型SCLC的CT影像特点.根据有无纵隔淋巴结转移及其大小,将78例周围型SCLC分为2型:Ⅰ型孤立病灶型、Ⅱ型肺内病灶+淋巴结型;又将Ⅱ型分为2个亚型:Ⅱa型,肺门、纵隔淋巴结短径<10 mm;Ⅱb型,肺门、纵隔淋巴结短径≥10 mm.结果 Ⅰ型7例,Ⅱ型71例,其中Ⅱa型8例,Ⅱb型63例.78例SCLC均为实性病变;圆形、类圆形52例,纺锤形、蠕虫状9例,其他形状17例.71例行CT增强扫描,9例呈均匀强化,58例呈不均匀强化,4例病灶内见大面积不强化坏死区.边缘光整65例,毛糙12例,模糊1例.支气管充气征3例,空泡征4例,钙化4例.分叶征46例,毛刺征5例;支气管血管束增粗、结节41例,胸膜凹陷6例,边缘磨玻璃影5例,血管集束征1例;肺气肿42例,阻塞性肺炎4例;支气管与结节边缘截断18例.纵隔淋巴结转移63例,纵隔淋巴结大于肺原发灶42例.少量胸腔积液9例.

CT signs of peripheral small cell lung cancer

Objective To investigate CT signs of peripheral small cell lung cancer (SCLC).Methods The CT signs of 78 patients with SCLC confirmed by pathology were retrospectively reviewed.According to the presence of mediastinal lymph node metastasis and its size, 78 cases of peripheral SCLC were divided into two types: typeⅠ(isolated lesion) and typeⅡ(lung lesion + lymph nodes).Type Ⅱwere divided into two subtypes:type Ⅱa (short diameter of lymph nodes of pulmonary hilar and mediastinum less than 10 mm) and type Ⅱ b (short diameter of lymph nodes of pulmonary hilar and mediastinum greater than or equal to 10 mm).Results Of the 78 SCLCs, typeⅠwas 7 cases, and typeⅡwas 71 cases,including 8 cases of typeⅡa and 63 cases of typeⅡb.All of the lesions were soild density.The shape were round or oval in 52 cases, vermicular or spindlein 9 cases, and other shapes in 17 cases.Among 71 cases performed CT enhancement, there were 9 cases with homogeneous enhancement, 58 cases with heterogeneous enhancement, 4 cases with non-enhancement large necrosis area.These cases showed the following CT signs: smooth edge in 65 cases, coarse edge in 12 cases, blurred edge in 1 case;air bronchogram in 3 cases, vacuole sign in 4 cases, calcification in 4 cases;lobulation sign in 46 cases, spiculated sign in 5 cases;thickening of the bronchovascular bundle in 41 cases, pleural indentation in 6 cases, marginal ground-glass opacity in 5 cases, vascular convergence sign in 1 case;emphysema in 42 cases;obstructive pneumonia in 4 cases;bronchus abruptly interruption on the edge of the nodules in 18 cases;enlargement of mediastinal lymph nodes in 63 cases, the diameter of mediastinal lymph nodes larger than the primary lesions in 42 cases;and a little pleural effusion in 9 cases.Conclusion Solid density, smooth margin with lobulation,and significantly enlarged mediastinal lymph nodes are common signs in peripheral SCLC.Thickening of the bronchovascular bundle indicates reletively advanced stage.