周围型肺腺癌的CT征象分析、诊断及鉴别诊断_临床医学论文.docVIP

周围型肺腺癌的CT征象分析、诊断及鉴别诊断_临床医学论文 周围型肺腺癌的CT征象分析、诊断及鉴别诊断_临床医学论文 【摘要】 目的 研究周围型肺腺癌CT表现及与病理之间的关联。 方法 回顾性分析102例经手术病理证实的周围型肺腺癌（其中高分化30例，中分化33例，低分化39例）主要CT征象进行比较分析。 结果 102例周围型肺腺癌的主要CT分析征象是：空气支气管征或空泡征、高分化腺癌24例（80％）、中分化腺癌10例（30.3％）、低分化腺癌无此征、毛刺征73例、棘突征52例、分叶征79例、胸膜凹陷征65例、血管集束征69例、病灶内钙化31例，其中67例出现上述三种以上征象。 结论 综合分析周围型肺腺癌的CT征象有利于提高对本病的诊断准确率。 【关键词】 肺肿瘤; 腺癌; 周围型; 体层摄影术; X线计算机; 诊断 [Abstract] Objective To evaluate the relationship between the CT featuers and pathology of peripheral adenocarcinoma. Methods The CT features of 102 patients with peripheral Lung adenocarnomas proved by operation and pathology were studied retrospectively (high differential adenocarcinoma 30 cases; moderate differential adenocarcinoma33 cases; low differential adenocarcinoma 39 cases). Results the basic CT features of 102 patients with Peripheral lung adenocarcinomas were as follows:vacuole or air bronchogra charging sign was found in which as were seen in 24 cases (80%) in high differential adenocarcinoma and were seen in 10 cases (30.3%) in moderate differential adenocarcinoma but not seen in low differential ones, spiculation sign in 73(71.5%). spiculate protulerance sign in 52 (50.9%). lobulation sign in 79(77.4%), pleural in dentation sign in 65(63.7%), vessel convergenoe sign in 69 cases(67.6%), and calcification inside the lesion was 31 cases. 67 cases had more then three basic CT signs mentioned above. Conclusion Comprehensive analysis of CT features is conductive to improve the accuracy of the diagnosis of peripheral lung adenocarcinomas. [Key words] lung neoplasex:adenocareinoma peripheral-type; computed tomography;X-ray computed; diagnosis 肺癌是最常见的恶性肿瘤之一，近年来发病率呈逐渐上升趋势，是现今癌症中死亡率最高的一种，肺癌的早期诊断较为困难，5年生存率大约为10%～15%以下[1]。 肺腺癌居肺癌第三位且又以周围型肺腺癌最常见[2]。本文对2004年3月～2007年11月我院收治的102例周围型肺腺癌病人的CT表现进行回顾性分析，并查阅有关文献资料，现报道如下： 材料与方法 1. 一般资料 周围型肺腺癌病人102例，术前行CT扫描并经手术及病理证实，男62例，女40例，年龄30～84岁，平均年龄60.3岁。其中高分化腺癌30例，中分化腺癌33例，低分化腺癌39例。临床上以咳嗽、咳痰为首发症状者63例，其中14例伴发热；13例有咳嗽伴痰中带血；12以胸闷、胸痛为主；5例为体检时发现；9例以骨性疼痛为首发症状。 2. CT扫描方法 采用SCT