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原發(fā)性肺黏液腺癌的影像學(xué)表現(xiàn)

發(fā)布時(shí)間:2018-11-20 13:10
【摘要】:目的探討原發(fā)性肺黏液腺癌(PPMA)的影像和臨床、病理特征及影像診斷價(jià)值。方法收集2011年3月—2014年3月寧波大學(xué)醫(yī)學(xué)院附屬醫(yī)院經(jīng)手術(shù)病理或穿刺活檢證實(shí)的7例PPMA患者的臨床、影像及病理資料。7例患者均行CT平掃,其中4例行CT多期增強(qiáng)掃描,1例行MR平掃及MR多期增強(qiáng)掃描。觀察其影像學(xué)表現(xiàn)并與臨床和病理結(jié)果進(jìn)行對(duì)照。結(jié)果 4例單發(fā)結(jié)節(jié)型,1例多發(fā)結(jié)節(jié)型,2例實(shí)變型,共9個(gè)病灶。外圍及胸膜下分布8個(gè),另1個(gè)占據(jù)整個(gè)肺左下葉。最大徑0.5~17.3 cm,平均(4.9±5.0)cm。7例病變均未見(jiàn)出血、鈣化,分葉、空泡征、血管集束征各4例,空氣支氣管征、支氣管截?cái)嗾、暈征、胸膜凹陷征?例,細(xì)小短毛刺、棘狀突起、碎石路征、衛(wèi)星播散病灶、血管造影征、肺葉膨隆各2例;3例呈囊實(shí)性,實(shí)性成分均以邊緣分布為主或內(nèi)部散在斑片樣分布;1例MR白肺征,實(shí)性成分彌散加權(quán)成像(DWI)明顯高信號(hào),表觀擴(kuò)散系數(shù)(ADC)值明顯降低。6例術(shù)后病理均為浸潤(rùn)型肺黏液腺癌,分期為Ⅰa期1例,Ⅱa期1例,Ⅲa期4例。1例穿刺活檢證實(shí)為肺黏液腺癌。結(jié)論 PPMA的影像及病理表現(xiàn)有一定的特異性,正確認(rèn)識(shí)其病理學(xué)特點(diǎn),有助于提高對(duì)其影像征象的理解和認(rèn)識(shí)。對(duì)懷疑肺黏液腺癌的肺實(shí)變患者應(yīng)常規(guī)行MR重T2加權(quán)像(T2WI)及DWI。
[Abstract]:Objective to investigate the imaging and clinical features, pathological features and diagnostic value of (PPMA) in primary pulmonary mucinous adenocarcinoma. Methods from March 2011 to March 2014, the clinical, imaging and pathological data of 7 patients with PPMA confirmed by surgical pathology or puncture biopsy in affiliated Hospital of Ningbo University Medical College were collected. MR plain scan and MR multiphase enhanced scan were performed in 1 case. Imaging findings were observed and compared with clinical and pathological findings. Results there were 4 cases of single nodular type, 1 case of multiple nodular type and 2 cases of solid type, with 9 lesions. Peripheral and subpleural distribution 8, the other one occupied the entire left lower lobe of the lung. The mean maximum diameter of 0.5 ~ 17.3 cm, was (4.9 鹵5.0) cm.7 without bleeding, calcification, lobulation, vacuole sign, vascular cluster sign in 4 cases, air bronchi sign, bronchial truncation sign, halo sign, pleural depression sign in 3 cases, respectively. Small short burr, spinous protuberance, lithotripsy sign, satellite spread lesion, angiographic sign, pulmonary lobus bulge in 2 cases; Saccular solid was found in 3 cases, and the distribution of solid components was mainly marginal distribution or internal speckle-like distribution. In 1 case with white lung sign of MR, (DWI) of solid component diffusion-weighted imaging was obviously high signal, and the (ADC) value of apparent diffusion coefficient was obviously decreased. The pathological features of 6 cases were infiltrating pulmonary mucinous adenocarcinoma, with stage 鈪,

本文編號(hào):2345004

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