20例细支气管肺泡癌的DR与CT表现分析

目的探讨细支气管肺泡癌的DR胸片与CT的表现特点及变化规律。方法收集经手术病理证实的20例细支气管肺泡癌的DR胸片及CT扫描结果进行回顾性分析。结果支气管肺泡癌分三型,即结节型,弥漫型,浸润型。结节型病灶聚集融合成结块状,结节影内密度不均,内可见小泡状低密度影;弥漫型病灶,多发弥漫性小结节状影逐渐融合成片状、大片状实变影;浸润型病灶,按肺段或肺叶分布,形似普通肺炎的表现,可见充气支气管征,CT增强可见典型“CT血管造影征”。结论无论是结节型,弥漫型和浸润型细支气管肺泡癌,其DR胸片及CT表现均有一定的特点:结节型,DR胸片可见病灶好发于肺外围,边缘有毛刺及胸膜凹陷征象,而其HRCT表现在纵隔窗上可见典型的小泡征;弥漫型,DR胸片呈散在分布多发粟粒样结节影,而CT表现比DR胸片更能发现多发病灶,HRCT特征表现是两肺广泛小结节影,可伴小叶间隔增厚;浸润型,DR胸片表现为肺实变及充气支气管征,而CT表现为CT血管造影征和低CT值肺实变阴影,具有特征性。掌握各型细支气管肺泡癌的DR胸片及CT表现,有助于提高细支气管肺泡癌的诊断。

Analyize manifestations of DR and CT of 20 cases of bronchioloalveolar carcinoma

Objective Exploring the characters and changing rules between DR chest fluoroscopy and CT of bronchioloalveolar carcinoma.Methods Collecting 20 cases DR chest fluoroscopies and CT scanning results of bronchioloalveolar carcinoma,proved by biopsy, to reviewing analysis. Results Bronchioloalveolar carcinoma divided into 3types, nodular type , diffused type, infiltrated type.Nodular type focuses congregate and fused into node,density of the nodular shadow bad- distributed,vesical low- density shadow showed; Diffused type focus,multiple diffused nodish shadow gradually fused into patech consolidated shadow; Infiltrated focus distributed to pulmonary segment or lobes, like common pneumonia feature, existed airobronchogram,CT contrast scan shows typical ' CT angiogram' .Conclusion No matter which type:nodular ,diffused or infiltrated type ,whose DR chest fluoroscopy and CT exists some features :Nodular type, DR chest fluoroscopy shows focuses mostly in periphery of pulmonary,margin with burr and plueral sunken sign,and whose HRCT manifestationshows typical small vesical sign in mediastinal window;Diffused type, DR chest fluoroscopy shows multiple diffusedgranular nodish shadow ,however , CT manifestation can find more multiple focus than DR chest fluoroscopy,typical manifestation of HRCT is extensive small nodular shadow,with the thicken lobular interal; Infiltrated focus : DR chest fluoroscopy shows pulmonary consolidation and airobronchogram , And CT manifestations are CT angiogram and low- density consolidation shadow,wth specific property.Master all types of manifestation of DR and CT of bronchioloalveolar carcinoma ,can help you improve the diagnosis of bronchioloalveolar carcinoma.