周围型肺癌阻塞性病变的CT表现(附18例分析)

目的:确定深呼吸时相CT扫描对周围型肺癌诊断敏感性。材料与方法:18例周围型肺癌(13例经病理证实,5例由其它方法证实)和12例良性肺肿块对照者(炎性假瘤和结核球等)均经常规CT扫描,除2例炎性假瘤患者外,其余所有病人并经肿块部位及其上下一层的深呼吸时相CT扫描。结果:周围型肺癌深呼吸时相CT扫描所见的阻塞性病变计有4例肺不张,12例阻塞性肺炎(按其帮位进而可分为远离肿块的和邻近肿块的阻塞性肺炎),1例阻塞性肺气肿,以及1例肺静脉癌栓。周围型肺癌的这些CT表现,在良性肺肿块对照者中不复被看到。结论:深呼吸时相CT扫描所见的远离肿块的阻塞性肺炎及肿块外侧的阻塞性肺气肿,可被看作是周围型肺癌的特有表现而且是其早期诊断的依据。

CT Findings of Obstructive Lesions in the Lung with Peripheral Lung Cancer (Report of 18 cases)

Purpose: To determine the diagnostic sensitivity of CT scan during breath - hold after deep inspiration and deep expiration in peripheral lung cancer. Materials and Methods: Eighteen patients with peripheral lung cancer (13 cases were proven pathologically, 5 cases were proven by other methods)and twelve controls with benign pulmonary mass(inflammatory pseudotumor and tuberculoma etc) all underwent conventional CT scan, except two patients with inflammatory pseudotumor. and then underwent thin slice scan in the location of mass during breath -hold after deep inspiration and deep expiration. Anatomic structures on CT after deep inspiration were well corresponding to that after deep expiration. Results: Obstructive lesions seen on CT of peripheral lung cancer were following four kinds: Four cases of atelectasis , twelve cases of obstructive pneumonia (according to the position of the lesions, it may be further divided into pneumonia distant to a tumor and pneumonia adjacent to a tumor), one case of obstructive emphysema, and one case of small pulmonary vein blocked by cancer cells. These CT findings found in peripheral lung cancer were not observed in controls with benign pulmonary mass. Conclusions: Obstructive pneumonia distant to a tumor, which was found on CT during breath - hold after deep inspiration and deep expiration, and obstructive emphysema found in the outside of tumor may be regarded as specific findings for peripheral lung cancer and important evidences for early diagnosis of lung cancer.