摘要
目的:研究孤立性肺结节(SPN)与支气管、血管的关系及其分型,并探讨其诊断价值。方法:对60例直径≤3cmSPN患者均行MSCT扫描,并进行图像后处理,显示SPN与相关支气管、血管的关系及其类型,并将结果与病理结果相比较。结果:①SPN与相关支气管、血管的关系及形态特征能良好显示。CT显示SPN与支气管有关系者恶性结节28例,良性结节13例;与血管有关系者恶性结节31例,良性结节22例;与支气管和血管均有关系者恶性结节23例,良性结节15例;②SPN与支气管关系分为4型:Ⅰ型,支气管于SPN边缘被截断;Ⅱ型,支气管到达SPN时变尖、变细或锥状中断;Ⅲ型,支气管在SPN内呈长段开放状,并可进一步分叉;Ⅳ型,支气管紧贴SPN边缘走行而不中断。SPN与支气管关系大部分表现为单型,亦可表现为多型共存。本文中Ⅰ型19例,Ⅱ型6例,Ⅲ型8例,Ⅳ型8例。③SPN与血管关系分5型:Ⅰ型肺血管于SPN边缘被截断,一支或多支末端杵状增粗;Ⅱ型肺血管于SPN边缘被截断,末端不呈杵状增粗;Ⅲ型显示为血管切迹征;Ⅳ型肺血管延伸进入或穿过SPN;Ⅴ型血管紧贴SPN边缘走行,或受压呈弧形改变。SPN与血管关系大部分表现为单型,也可表现为混合型。本文中Ⅰ型16例,Ⅱ型10例,Ⅲ型10例,Ⅳ型9例,Ⅴ型8例。结论:采用MSCT薄层扫描,结合MPR、CPR、VR能准确显示SPN与支气管、血管的关系及其分型,将两者结合对SPN良恶性性质的诊断和鉴别有重要价值。
Objective：To investigate the relationship of solitary pulmonary nodule （SPN） with bronchus and blood vessels as well as its classification by multi-slice CT （MSCT）, the value of diagnosis was also studied. Methods： Of 60 patients having pulmonary SPN with the diameter≤3cm were exaimined with MSCT. The characteristics of SPN and its relationship with corresponding bronchi and blood vessels were displayed and correlated with that of pathology. Results ： ①The relationship of SPN and corresponding bronchus, blood vessels were very clearly showed on CT. The relationship of SPN with bronchus were showed in 28 malignant and 13 benign nodules; the relationship between SPN and blood vessels were showed in 31 malignant and 22 benign nodules;with both bronchus and blood vessel in 23 malignant and 15 benign nodules. ②The SPN-bronchus relationship was classified into four types on MSCT： Type Ⅰ , the bronchus interrupt at the edge of SPN;Type Ⅱ, bronchus reach the edge of SPN with tapering, narrowing or cone-shaped interruption; Type m ,long segment of patent or even bifurcated bronchus within the SPN ; Type Ⅳ, bronchus compressed by the SPN with no interruption. Most of the SPN-bronchus relationship were displayed as single type, yet co-existence of multiple types could also be assessed. The SPN-bronchus relationship in this group of patients were as follow： type Ⅰ （n = 19）; type Ⅱ （n = 6） ; type Ⅲ （n = 8） ; type Ⅳ （n= 8）. ③The SPN vascular relationship was classified into five types on MSCT：Type I ,blood vessels were interrupted abruptly at the edge of SPN, with clubbed ending in one or more vessels;Type Ⅱ , blood vessels interruption at the edge of SPN yet with no clubbed ending;Type Ⅲ,vascular notch sign;Type Ⅳ ,blood vessels penetrated into SPN; Type Ⅴ , blood vessels closely aligned at the periphery of SPN with intact lumen or being compressed by SPN. Most of the SPN-vascular relationship displayed as single type, yet mixed type could also be revealed. The SPN-vascular relationship in this group of patients was as follows：Type Ⅰ（n=16）;Type Ⅱ （n=10）;Type Ⅲ （n=10） ;Type Ⅳ（n=9）;Type Ⅴ（n=8）.Concluslon：The relationship of SPN bronchial / blood vessel as well as their classification could be displayed on thin-slice MSCT scanning in combination with post-processing techniques including MPR,CPR and VR, which was helpful in the diagnosis and differential diagnosis of the nature （benign / malignant） of SPN.
出处
《放射学实践》
北大核心
2009年第5期476-479,共4页
Radiologic Practice
