CAJ | 학술논문

目的：探讨周围型肺癌伴薄壁空腔形成的CT表现与征象特点，提高对该类型肺癌的认识和诊断准确性。方法回顾性分析经手术和（或）病理证实的周围型肺癌伴空腔形成患者31例[男18例、女13例；平均年龄（56±12）岁]。31例患者中，肺腺癌28例、鳞状细胞癌2例、肉瘤样癌1例。所有患者均行MSCT检查，并分析肺癌实性与空腔病灶的CT征象，包括空腔与肺癌实体病灶位置关系、腔壁厚度及均匀度、内壁结节、外壁有无血管影相贴、腔内有无分隔、气-液平面以及动态变化等。结果（1）肺癌实体病灶：多见于两肺中上叶占67.7%（21/31），分叶征、毛刺征与血管集束征分别占87.1%（27/31）、67.7%（21/31）和51.6%（16/31）；20例（64.5%）表现为磨玻璃密度结节（GGN），其中纯GGN者占11例（35.5%）。（2）空腔病灶：病灶直径为（2.7±1.3）cm；位于实性病灶周边者26例（83.9%），其中外侧及上、下外侧者20例（64.5%）；壁较均匀17例（54.8%），壁厚<2 mm占51.6%（16例），2~3 mm占32.3%（10例）；伴内壁结节5例（16.1%），外壁见相贴或推移血管者12例（38.7%）；均未见气-液平面，27例（87.1%）腔内见粗细不均间隔或细小血管影。结论周围型肺癌伴薄壁空腔形成者绝大多数见于腺癌，其薄壁空腔的CT表现具有一定特征，有助于提示该类型肺癌的临床诊断。
목적：탐토주위형폐암반박벽공강형성적CT표현여정상특점，제고대해류형폐암적인식화진단준학성。방법회고성분석경수술화（혹）병리증실적주위형폐암반공강형성환자31례[남18례、녀13례；평균년령（56±12）세]。31례환자중，폐선암28례、린상세포암2례、육류양암1례。소유환자균행MSCT검사，병분석폐암실성여공강병조적CT정상，포괄공강여폐암실체병조위치관계、강벽후도급균균도、내벽결절、외벽유무혈관영상첩、강내유무분격、기-액평면이급동태변화등。결과（1）폐암실체병조：다견우량폐중상협점67.7%（21/31），분협정、모자정여혈관집속정분별점87.1%（27/31）、67.7%（21/31）화51.6%（16/31）；20례（64.5%）표현위마파리밀도결절（GGN），기중순GGN자점11례（35.5%）。（2）공강병조：병조직경위（2.7±1.3）cm；위우실성병조주변자26례（83.9%），기중외측급상、하외측자20례（64.5%）；벽교균균17례（54.8%），벽후<2 mm점51.6%（16례），2~3 mm점32.3%（10례）；반내벽결절5례（16.1%），외벽견상첩혹추이혈관자12례（38.7%）；균미견기-액평면，27례（87.1%）강내견조세불균간격혹세소혈관영。결론주위형폐암반박벽공강형성자절대다수견우선암，기박벽공강적CT표현구유일정특정，유조우제시해류형폐암적림상진단。
Objective To study the CT features of peripheral lung cancer with thin-walled cavity, and to improve the understanding and diagnostic accuracy of this type of lung cancer. Methods Thirty-one patients (male:18, female:13, average age(56 ± 12)years old) with surgically proven peripheral lung cancer with thin-walled cavity were studied retrospectively. There were 28 cases of adenocarcinoma, 2 cases of squamous cell carcinoma and 1 case of sarcomatoid carcinoma. All patients had MSCT examination, and the CT features of the solid lesion and thin-walled cavity of the lung cancer were analyzed. The relationship between solid lesion and thin-walled cavity location, cavity wall thickness and uniformity, wall nodules, vascularstructures close to the outer wall, septum or air-fluid level inside the cavity, and dynamic changes of the lesions were all evaluated. Results (1) Solid lesion:mostly located in both upper and middle lobes of the lung in 21cases (67.7%). Lobulation, speculation and vessel convergence sign were observed in 27 cases (87.1%), 21 cases(67.7% )and 16 cases(51.6%) respectively. Twenty cases showed as ground glass nodule (GGN) (64.5%), with pure GGN in 11 cases(35.5%). (2) Cavitary lesion: The average diameter was (2.7 ± 1.3) cm, the cavity located in the periphery of the solid lesions in 26 cases (83.9%),and in 20 cases (64.5%) located in the lateral or superior and inferior lateral aspect of the solid lesion;The cavity wall was uniform in17 cases (54.8%) and the wall thickness<2 mm were seen in 16 cases (51.6%), 2-3 mm were observed in 10 cases (32.3%);Wall nodules were seen in five cases (16.1%);Blood vessels adjacent to outer wall were found in 12 cases (38.7%);There was no air-fluid level in the cavity in all the cases;But septum with uneven thickness or small vessels were seen in the cavity in 27 cases (87.1%). Conclusions The majority of peripheral lung cancer with thin-walled cavity was adenocarcinoma, characteristic CT features of thin-walled cavitary lesions may be helpful in the diagnosis of this type of lung cancer.