小肺癌SCT漏／误诊5例CT征像分析.pdfVIP

M M I BIMONTHLY Vol18 No．1 Feb2o09 — 19一 小肺癌 SCT漏／误诊5例 CT征像分析 中山大学附属第五医院放射科(广东珠海市519000) 谈 高 韩 军 黄 略 李颖勤 【摘要】 目的：确定初次SCT漏／误诊而后 cT扫描检测到的小肺癌 CT征象。材料与方法：复习2490例初次 SCT普查中漏／误诊患者的CT征象，回顾性评价其 CT征象、检测时间、细胞类型及病理分期。结果：初次SCT扫 描漏误诊小肺癌5例 ，其中4例病检肺癌为 1期 ，1例为 Ⅱ期。结论：SCT普查可漏／误诊接近检测阈的小肺癌结 节，慎用双窗观察，推荐随访检查。 关键词：肺癌 螺旋 CT(SCT) 普查 漏／误诊 MissedDetectionandFailuresDiagnosisinSpiralCT Screening forIungCancer：AnalysisofCT Findingsof5Cases TanGao HanJun HuangLue LiYingqin DepartmentofRadiologyFifthAffiliatcdHospitalofSunYat—senUniversity，Zhuhai519000 A【bstract】 Purpose：Toclarifythecomputedtomographic(CTfindingsandtheprogrssionofminutelungcnacersthat missedorfailureddiagnosisatinitialspiralCTscreeningbutwere laterdetected．MaterialsandM ethods：Thefindingsfrom fivepatientswithlungcna cerhtatwasmissde orfailureddiagnosisattheinitialspiralCTscreeningwerereviewed．Retrospce— fiveCTfindings，timetodetection，celltype，andpathologicstagewereevaluated．Results：Minutelungcsncersmissedor failureddiagnosisatearlyspiralCTincludedanoduleamongtheshadowsofoldtuberculosis(n=1)，afaintnodulewitllhigh attenuationinthecenterofthenodule(n=1)，na increaseinattenuationjustadjacenttoanaxialperipheralpulmonaryvessel (n=1)andadjacenttoacraniceaudalperipheralpulmonaryvessel(n：1)，andaminutefaintnodul(n=1)．Thetimetode— tcetionrnagedfrom 6—18months．Atpathologicexamination，fourcancerswerestageI，nadon—werestageII。Conclu- sion：Minutenodulesoflungcnacerhtatmaybemissedorfailurde diagnosisatspiralCTscreening．Itisimportnattoexamine noncalcifiednoduleswithhig【hresolutionCT(HRCT)evenwhenlesionsfrompriordiseases，suchashtosefromoldtubemul~ sis，existandtoevaluatehte shadowsofpulmonaryvesselscarefullyA follow—upexamination