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目的探讨多层螺旋CT三维重组对孤立型细支气管肺泡癌(bronchioloalveolar carcinoma,BAC)的诊断价值。资料与方法经病理证实的孤立型BAC 35例,分析高分辨率CT(HRCT)扫描、多平面重组(MPR)和容积再现(VR)技术对孤立型BAC基本征象的显示价值,并与常规横断位图像对比分析。结果35例孤立型BAC根据CT图像上病灶密度表现将病灶分为3种类型:(1)单纯磨玻璃密度结节(8例);(2)混杂密度结节(20例);(3)单纯实性密度结节(7例)。HRCT、MPR及VR在显示孤立型BAC的空泡征、纯磨玻璃征、环晕征、分叶征、毛刺征、胸膜凹陷征及支气管血管集束征方面优于常规横断位。结论HRCT及三维重组,较常规横断位扫描能更准确地显示孤立型BAC的内部细微结构及周围形态改变,对孤立型BAC诊断具有重要价值。
Objective To investigate the value of multi-slice spiral CT three-dimensional reconstruction in the diagnosis of solitary bronchioloalveolar carcinoma (BAC). Materials and Methods 35 cases of isolated BAC confirmed by pathology were analyzed. The diagnostic value of high resolution CT (HRCT), multiplanar reconstruction (MPR) and volumetric reconstruction (VR) on the basic signs of isolated BAC was analyzed and compared with the conventional transverse Bit image contrast analysis. Results 35 cases of solitary BAC were classified into three types according to the lesion density on the CT images: (1) purely ground glass density nodules (8 cases); (2) mixed density nodules (20 cases); (3) Simple solid density nodules (7 cases). HRCT, MPR, and VR were superior to conventional transverse dislocations in displaying vacuolar sign, pure glass sign, ring halo sign, leaflet sign, burr sign, pleural indentation and bronchovascular bundling sign of isolated BAC. Conclusion HRCT and three-dimensional reconstruction, compared with conventional transverse scintigraphy, can more accurately show the internal microstructure and surrounding morphological changes of isolated BAC, which is of great value in the diagnosis of solitary BAC.