张广州 王代明

【摘要】 目的：研究中早期肺癌多層螺旋CT（MSCT）图像表现及MSCT的诊断价值。方法：回顾性分析医院2018年1月-2019年3月收治的98例经病理检查确诊的早期肺癌患者临床资料，患者均行MSCT检查并具有完善的影像学资料，分析其MSCT图像表现，评估MSCT在诊断早中期肺癌中的临床价值。结果：以病理检查结果作为金标准，MSCT漏诊8例，诊断正确率为91.84%;MSCT对周围型中早期肺癌诊断准确率高于中央型，但差异无统计学意义（P>0.05）。35例中早期周围型肺癌患者中，有71.43%的患者MSCT影像有分叶征表现，65.71%存在毛刺征，45.71%存在胸膜凹陷及血管集束征，31.43%出现空泡征或支气管充气征;63例中央型中早期肺癌中，管内型中央型肺癌MSCT图像有管腔呈偏心性狭窄或阻塞，病灶局部软骨环消失，管壁型中央型肺癌有管壁增厚，管壁肿胀等表现，管外型中央型肺癌有管腔变形，表面欠光滑表现。肿瘤灌注参数提示，中央型肺癌BF、BV水平显著高于中央型肺癌患者（P<0.05），两组MTT及PS水平差异无统计学意义（P>0.05）。结论：MSCT空间、时间分辨率高，能有效提示中早期肺癌病灶征象，在诊断中早期肺癌中具有较高的临床价值，MSCT对中央型中早期肺癌的诊断效果不及周围型肺癌，但中央型肿瘤内部灌注参数低于周围型，可为其诊断提供参考。

【关键词】 多层螺旋CT 早中期肺癌 图像表现 诊断价值

doi：10.14033/j.cnki.cfmr.2019.30.028 文献标识码 B 文章编号 1674-6805（2019）30-00-03

[Abstract] Objective： To study the imaging manifestations of multislice spiral CT （MSCT） and the diagnostic value of MSCT in early stage lung cancer. Method： A retrospective analysis was made of the clinical data of 98 patients with early lung cancer diagnosed by pathological examination in our hospital from January 2018 to March 2019. All patients underwent MSCT examination and had perfect imaging data. The MSCT image manifestations were analyzed and the clinical value of MSCT in the diagnosis of early and middle lung cancer was evaluated. Result： According to the gold standard of pathological examination， 8 cases were missed by MSCT， the diagnostic accuracy rate was 91.84%. The diagnostic accuracy of MSCT for peripheral middle and early lung cancer was higher than that of central lung cancer， but there was no statistical difference （P>0.05）. Among 35 cases of middle and early peripheral lung cancer， 71.43% of the patients had lobulated MSCT images and 65.71% had burr signs， 45.71% had pleural depression and vascular cluster sign， 31.43% had vacuole sign or bronchial inflatability sign. In 63 cases of central lung cancer， MSCT images of central lung cancer showed eccentric stenosis or obstruction of lumen， disappearance of local cartilage ring， wall thickening， wall swelling and other manifestations， lumen deformation and surface underlighting of central lung cancer. The BF and BV levels of central lung cancer were significantly higher than those of central lung cancer （P<0.05）， there was no significant difference in MTT and PS levels between the two groups （P>0.05）. Conclusion： MSCT has high spatial and temporal resolution， which can effectively indicate the signs of early and middle lung cancer. It has high clinical value in the diagnosis of early and middle lung cancer. The diagnostic effect of MSCT on central lung cancer is inferior to that of peripheral lung cancer， but the internal perfusion parameters of central lung cancer are lower than those of peripheral lung cancer， which can provide reference for its diagnosis.

[Key words] Multi-slice spiral CT Early and middle stage lung cancer Imaging findings Diagnostic value

First-authors address： Honghu Second Peoples Hospital， Honghu 433200， China

肺癌是我国临床发病率最高的恶性病变之一，中早期肺癌临床症状不明显，难以确诊，是延误患者治疗的主要原因[1，2]。多层螺旋CT（MSCT）是临床诊断的常用影像学方式，其具有较高的时间、空间分辨率，能有效提示病灶及其周围组织情况[3-4]。总结……