衣家奇 张楠 谭红艳 杨丽

[摘要] 目的 探讨多层螺旋CT 检查在诊断周围型肺癌中的应用价值。 方法 选择2019年1月至2020年12月在我院住院治疗的周围型肺癌患者 200 例作为本研究观察对象，全部入选患者根据检查方法不同分为观察组和对照组，每组各100例。对照组采用X线检查，观察组采用CT检查，对比两组不同征象的检查率。 结果 多层螺旋CT显示，见周围型肺癌瘤体的强化密度不均，多数形态不规则，少数呈类圆形;病灶较大3例，其周围肺纹理增多、扭曲，以肺门侧为重。直接征象表现为：肺外周组织内出现圆形或不规则形态的高密度肿块，其中边缘有毛刺者112例，鳞癌患者中出现短细毛刺12 例， 未分化癌患者中出现 3 例短细毛刺。肿瘤间接征象表现为：纵膈淋巴结肿大、胸膜凹陷征及少量钙化和空洞。观察组患者的分叶征、毛刺征、厚壁空洞及肺门和纵隔淋巴结肿大的检出率显著高于对照组，差异有统计学意义（P<0.05）。 结论 螺旋 CT 具有操作简便、影像分辨率高、扫描时间短的优势，能够有效观察微小病灶位置、形态、内部结构、疾病征象等，且其还可以提升对比剂利用率，进行任意、回顾性图像重建，不受层间隔大小约束，用于周围型肺癌中的臨床价值较高，对病灶检出率高，值得推广和应用。

[关键词] 多层螺旋CT;X线;周围型肺癌;应用价值

[中图分类号] R734.2          [文献标识码] B          [文章编号] 1673-9701（2021）36-0112-04

The application value of multilayer spiral CT examination in the diagnosis of peripheral lung cancer

YI Jiaqi   ZHANG Nan   TAN Hongyan   YANG Li

Room of Computed Tomography-Magnetic Resonance Imaging， East Branch of the Central Hospital of Jiamusi City in Heilongjiang Province，Jiamusi   154000，China

[Abstract] Objective To explore the application value of multilayer spiral CT examination in the diagnosis of peripheral lung cancer. Methods A total of 200 patients with peripheral lung cancer who were hospitalized in our hospital from January 2019 to December 2020 were selected as the observation subjects of this study. All the selected patients were divided into the observation group and the control group according to different examination methods，with 100 cases in each group. The control group underwent X-ray examination and the observation group underwent CT examination，and the detection rates of different signs were compared between the two groups. Results The multilayer spiral CT showed that the enhancement density of the tumor bodies of peripheral lung cancer was uneven，most of them were irregular in shape，and a few of them were round-like. Three cases had relatively large lesions with increased and distorted surrounding lung texture， which were mainly found at the hilum of the lung. The direct signs were round or irregularly shaped high-density masses in the peripheral lung tissue，including burrs on the edge in 112 cases，and short and fine burrs were found in 12 patients with squamous carcinoma and 3 patients with undifferentiated carcinoma. The indirect signs were enlarged mediastinal lymph nodes，pleural depression，and a few calcifications and cavities. The detectable rates of lobulation， spiculation， cavity with thick wall and enlarged hilar， mediastinal lymph nodes in the observation group were higher than those in the control group，with significant differences（P<0.05）. Conclusion Spiral CT has the advantages of simple operation， high image resolution and short scanning time. It can effectively observe the location，shape，internal structure and disease signs of small lesions. It can also improve the utilization rate of contrast agent，carry out arbitrary and retrospective image reconstruction，and is not constrained by the size of interlayer interval. It has high clinical value in peripheral lung cancer and high detection rate of lesions，which is worthy of popularization and application.

[Key words] Multilayer spiral CT; X-ray; Peripheral lung cancer; Application value

周围型肺癌是一种起自三级支气管以下，且在呼吸性细支气管以上的肺癌，多见于腺癌， 病死率及恶性度较高[1]。……