肺炎型肺泡癌增强 CT 扫描及CT 导引下活检的临床应用.pdfVIP

作者简介:刘景旺(197 6- ),男,河北省遵化市人,副主任医师,主 要从事胸部影像学诊断工作。 基金项目:河北省科技计划项目(1227 7 1 1 3)。 ■介入放射学■ Interventional Radiology 肺炎型肺泡癌增强 CT 扫描及 CT 导引下活检的临床应用 刘景旺,刘运秋,李　健,张亚杰,郭庆乐 (河北联合大学附属开滦总医院影像科,河北　唐山　063000) 　　摘要:目的　探讨肺炎型肺泡癌(BAC)的 CT 表现特点及 CT 导引穿刺活检的应用价值。方法　 回顾分析病理证实的 1 4 例肺 炎型 BAC 的影像学特征。结果　14 例肺炎型 BAC 中,实变肺组织内支气管充气征 1 0 例(71.4%),实变肺组织内蜂房状气腔或空 洞征 5 例(35.7%),实变区周围呈现磨玻璃密度影及多发结节影 5 例(35.7%);增强 CT 扫描实变区可见混杂的低密度区内血管造 影征 1 1 例(78.6%),平均达峰时间为 90 s,时间-密度曲线呈速升缓降型 9 例(64.2%)。结论　CT 平扫表现肺段、叶性实变区内蜂 窝状气腔及空洞、血管造影征、枯树枝征及周围多发腺泡结节及磨玻璃密度区、增强扫描实变区可见血管造影征,时间-密度曲线呈 速升缓降型是肺炎型 BAC 的主要特点;CT 引导肺穿刺活检是较理想的确诊手段,二者结合可以大大提高早期诊断率。 关键词:肺泡癌;计算机体层成像;穿刺活检　　DOI:10.39 6 9/j.issn.1002-1 6 7 1.2014.1 1.029 中图分类号:R734.1;R814.42　　文献标志码:A　　文章编号:1 002-1 6 7 1(20 1 4)1 1-1883-04 The application of CT and CT-guided percutaneous puncture biopsy in diagnosis of pneumonic type bronchio-loalveolar carcinoma LIU J ingwang ,LIU Yunqiu,LI J ian,ZHANG Yaj ie,GUO Qing le (Department of Radiology ,the Affiliated Kailuan Hospital of Hebei United University ,Tang shan　063000,China) 　　Abstract:Objective　To evaluate imaging featuers and the application value of CT-guided percutaneous puncture biopsy combined with CT in diagnosing pneumonic type of bronchio-alveolar carcinoma (BAC).Methods　The features of CT findings of 1 4 cases with pathologically-proved pneumonic type of BAC were retrospective analyzed.Results　In consolidation of the lung tissue,air bron- chogram,honeycomb or air cavity sign,multiple nodules and/or ground glass opacity,and angiogram sign in contrast-enhance scan- ning were found in 1 0,5,5,and 1 1 of the 14 patients,mainly manifesting in pneumonic type of BAC.The mean time-to-peak was 90 s.The pattern of time density curve (TDC)was rapidly ascending-slowly descending in 9 cases.Conclusion　The significant find- ings of CT for BAC are not only air bronchogram,honeycomb or air cavity sign,multiple nodules and/or ground glass opacity,an- giogram sign but also the pattern of rapidly ascending-slowly descending TDC.CT-guide