伴薄壁空腔的周围型肺癌CT特点及征象分析

【摘要】目的：分析伴有薄壁空腔的周围型肺癌的CT特点及征象，提高对此疾病的认识和诊断水平。方法：回顾性分析天津市胸科医院2014年至2018年间经手术或穿刺活检病理证实的伴有薄壁空腔的周围型肺癌患者12例（男性9例，女性3例；年龄45~77，平均年龄55±11岁），薄壁定义为≤4mm，排除无病理结果证实的病例。分析CT图像特点和征象，包括病灶的边缘、空腔大小，空腔壁的厚度，壁内结节，空腔分隔等。结果：病灶位于双肺下叶的占83%（10/12），位于双肺上叶的占17%（2/12），空腔壁不规则增厚占100%（12/12），壁内结节占17%（2/12），空腔内分隔占50%（6/12），病灶边缘不光滑占92%（11/12），分叶占67%（8/12），毛刺67%（8/12），胸膜凹陷占33%（4/12），血管聚集25%（3/12），病灶周围磨玻璃密度影占17%（2/12）。2例增强检查患者壁结节明显强化。结论：伴有薄壁空腔的周围型肺癌好发于双肺下叶，CT表现具有一定的特征，有助于提高此疾病临床诊断。

CT features and signs of peripheral lung cancer with thin-walled cavity

【Abstract】Objective: To analyze the CT features and signs of peripheral lung cancer with thin-walled cavities and to improve the understanding and diagnosis of this disease. Methods: A retrospective analysis of 12 patients with peripheral lung cancer with thin-walled cavities confirmed by surgery or biopsy from 2014 to 2018 in Tianjin Chest Hospital (9 males and 3 females; age 45-77, The mean age was 55 ± 11 years), the thin wall was defined as ≤ 4 mm, and cases confirmed without pathological results were excluded. The characteristics and signs of CT images were analyzed, including the edge of the lesion, the size of the cavity, the thickness of the cavity wall, the nodules in the wall, and the separation of the cavity. Results: The lesions were located in the lower lobe of the lungs (83% (10/12), 17% (2/12) in the upper lobe, and the irregular wall thickening accounted for 100% (12/12). The internal nodules accounted for 17% (2/12), the cavity separation accounted for 50% (6/12), the lesion edge was not smooth at 92% (11/12), and the lobes accounted for 67% (8/12), burrs 67% (8/12), pleural indentation accounted for 33% (4/12), vascular aggregation 25% (3/12), and the density of ground glass around the lesion accounted for 17% (2/12). Two patients with enhanced examination showed significant enhancement of wall nodules. Conclusion: Peripheral lung cancer with thin-walled cavities occurs in the lower lobe of the lungs. CT features have certain characteristics and help to improve the clinical diagnosis of this disease.