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目的 探讨多层螺旋CT对肺小腺癌的诊断价值。方法 14例患者行多层螺旋CT薄层容积扫描 ,经工作站后处理分别获得多层面重建 (MPR)、最小密度投影 (MinIP)等重建图像 ,病变的影像特征与临床病理对照。结果 14例肺小腺癌的密度改变有 2种形式 :5例支气管肺泡癌中 4例可见磨玻璃密度 ,9例腺癌皆为实质性密度 ,3例支气管肺泡癌表现为空气支气管征与磨玻璃密度混合存在。多层螺旋CT薄层扫描所获得的MPR图像在 14个病例中均清晰显示叶间胸膜 ,并可对叶间胸膜的牵拉和破坏做出准确判断 ,10例MinIP可看到 5～ 6级支气管 ,使周围型小腺癌内空气支气管征的观察更直观。结论 多层螺旋CT薄层扫描及后处理图像对小腺癌的诊断是一种具有很大价值的检查手段。
Objective To investigate the diagnostic value of multislice spiral CT in small adenocarcinoma of the lung. Methods Fourteen patients underwent multi-slice spiral CT volume scan. After reconstruction of multi-planar reconstruction (MPR) and minimum intensity projection (MinIP), the imaging features of the lesions were compared with clinical pathology. Results There were two forms of density change in 14 cases of small adenocarcinoma of the lung: 5 cases of bronchial alveolar carcinoma showed ground glass density in 4 cases, 9 cases of adenocarcinoma were all substantial density, and 3 cases of bronchioloalveolar carcinoma showed air bronchogram and abrasion. The glass density is mixed. The MPR images obtained by thin-layer multi-slice spiral CT scan clearly show the interpleural pleura in 14 cases, and can accurately determine the traction and destruction of the inter-leaf pleura. 10 MinIP can be seen in grades 5 to 6 The bronchus makes the observation of air bronchograms in peripheral small adenocarcinoma more intuitive. Conclusion Multi-slice spiral CT scans and post-processing images are valuable tools for the diagnosis of small adenocarcinomas.