血管集束征在CT诊断周围型小肺癌中的价值.docVIP

血管集束征在CT诊断周围型小肺癌中的价值中华肿瘤杂志 1999年第6期第21卷 临床应用作者：于丽娟　张红霞　王晓红　曲丽英　于树江单位：于丽娟　张红霞　曲丽英　于树江　150040 哈 尔滨医科大学第三临床医学院放射科；王晓红　肿瘤内科　　关键词： 肺肿瘤/放射摄影术；体层摄影术，X线计算机　　【摘要】　目的　探讨血管集束征在CT诊断周围型小肺癌中的价值。方法　对123例直径≤3 cm的肺内孤立结节实施了薄层CT扫描。经手术病理和临床证实，其中周围型小肺癌83例，良性病变40例。91例手术切除标本做成病理大切片与CT进行对比研究，重点观察血管集束征的CT及病理表现。结果　血管集束征在周围型小肺癌中的出现率为65.1%(54/83)，在良性病灶的出现率为20.0%(8/40)。良恶性病灶之间差异有非常显著性(χ2=22.75，P＜0.001)。病理切片显示，集束的血管由扩张的小动脉或小静脉构成。结论　薄层CT扫描能较好的显示病灶与血管的关系，血管集束征是诊断周围型小肺癌有价值的CT征象。The value of “blood vessel convergency” sign in the diagnosis of small peripheral lung cancerYU Lijuan, ZHANG Hongxia, WANG Xiaohong, et al. Department of Radiology, The Third Hospital, Harbin Medical University, Harbin, 150040　　【Abstract】　Objective　To evaluate blood vessel convergency (BVC) sign in the radiologic diagnosis of small peripheral lung cancer.Methods　A prospective thin-section CT-pathology comparative study was done in 123 cases with solitary pulmonary nodules less than 3 cm in diameter including 83 peripheral lung cancera (adenocarcinoma 46, squamous-cell carcinoma 21, bronchiolo-alveolar-cell carcinomas 7, undifferentiated carcinoma 6, adenosquamous carcinoma 3) and 40 benign lesions. They were pathologically and clinically confirmed. Serial transverse sections of the surgically resected specimens were examined microscopically in 91 cases. Attention was focused on the imaging and histological manifestations of BVC.Results　BVC was found in 54(65.1%) peripheral lung cancers and in 8(20%) benign nodules (χ2=22.75, P＜0.001). Histologically, the convergent vessels were shown to be dilated arterioles or venules.Conclusion　Blood vessel convergency can be regarded as a valuable sign for the diagnosis of small peripheral lung cancers.　　【Subject words】　Lung neoplasms/radiography　　Tomography, X-ray computed　　近年来，肺内孤立结节(SPN)的CT报道较多，但多偏重病灶边缘及内部特点［1，2］，对结节周围血管的研究相对较少［3］。我们从1990年开始，共对123例SPN进行了CT扫描，并对手术切除病灶进行了CT和病理对照研究。　　材料与方法　　本组123例SPN(直径≤3 cm)患者中，男84例，女39例，男女之比约为2.15∶1。年龄范围28～70岁。有91例行手术切除，23例分别经支气