CAJ | 학술논문

背景与目的周围型肺癌的胸膜转移率较高，且干性胸膜转移术前容易漏诊，造成不必要的手术，因此术前诊断就尤为重要。回顾性分析伴有干性胸膜转移的周围型肺癌的多层螺旋CT（multislice spiral computed tomography, MSCT）影像，并探讨其对干性胸膜转移的诊断价值。方法对27例经病理或临床证实的周围型肺癌伴有干性胸膜转移的MSCT影像学表现进行回顾性分析。结果本组27例干性胸膜转移，CT检出率为85%，叶间胸膜转移检出率为91%，非叶间胸膜检出率为63%。27例中多发胸膜结节者26例（96%），所有胸膜结节均位于病变同侧，有叶间胸膜结节者23例，多表现为小结节，可沿叶间胸膜呈串珠样或簇状排列；有非叶间胸膜结节者8例，以大结节多见，肺-结节界面清晰；27例中胸膜增厚者15例（56%），可表现为胸膜带状增厚、不均匀增厚或两者同时存在。本组干性胸膜转移者影像学表现以混合型多见（63%）。结论 MSCT对周围型肺癌患者干性胸膜转移有较好的诊断价值，尤其对表现为胸膜结节者有较高的准确性。
배경여목적주위형폐암적흉막전이솔교고，차간성흉막전이술전용역루진，조성불필요적수술，인차술전진단취우위중요。회고성분석반유간성흉막전이적주위형폐암적다층라선CT（multislice spiral computed tomography, MSCT）영상，병탐토기대간성흉막전이적진단개치。방법대27례경병리혹림상증실적주위형폐암반유간성흉막전이적MSCT영상학표현진행회고성분석。결과본조27례간성흉막전이，CT검출솔위85%，협간흉막전이검출솔위91%，비협간흉막검출솔위63%。27례중다발흉막결절자26례（96%），소유흉막결절균위우병변동측，유협간흉막결절자23례，다표현위소결절，가연협간흉막정천주양혹족상배렬；유비협간흉막결절자8례，이대결절다견，폐-결절계면청석；27례중흉막증후자15례（56%），가표현위흉막대상증후、불균균증후혹량자동시존재。본조간성흉막전이자영상학표현이혼합형다견（63%）。결론 MSCT대주위형폐암환자간성흉막전이유교호적진단개치，우기대표현위흉막결절자유교고적준학성。
Background and objective hTe rate of pleural metastasis in peripheral lung cancer is high, and the dry pleural metastasis easily missed diagnosis preoperatively and cause unnecessary surgery. hTerefore, preoperative diagnosis is particularly important. To review the multislice spiral computed tomography (MSCT) image of peripheral lung cancer with dry pleural dissemination, and to discuss its diagnostic value for understanding the dry pleural dissemination. Methods Re-viewed and analyzed the MSCT images of pathologically or clinically diagnosed peripheral lung cancer with dry pleural dis-semination in 27 patients. Analyze the imaging characteristics respectively from pleural thickening and pleural nodules. Results hTe dry pleural dissemination of lung cancer were detected in 85%by CT. hTe rate of CT detection of dissemination on the visceral pleura and the interlobar pleura were 63%and 91%, respectively. 26 cases were with multiple pleural nodules, all were located on the same side with the primary lesions;8 cases were with peritoneum visceralis nodules that are mostly circular with diameters of 3 mm-15 mm. hTe lung-nodules interfaces were clear. 23 cases had interlobar pleura nodules (all with more than 6 nodules), some are big (diameter>5 mm) while some are small (diameter<5 mm). hTe nodules are arranged along the interlobar pleura as beaded string or in clusters around the interlobar pleura. 15 cases were with pleural thickening, including band-like, uneven, or both exist at the same time. hTere are more mixed type in this group (63%). Conclusion MSCT has great diagnostic value for peripheral lung cancer with dry pleural dissemination, especially with high accuracy of pleural nodules.