17例弥漫型细支气管肺泡癌的CT特征分析

目的：回顾性分析17例弥漫型细支气管肺泡癌（DBAC）的CT表现，探讨其特征性CT征象。方法：17例病理证实DBAC，其中实变型13例，多结节型4例。同时搜集13例叶／段性肺炎为对照组。结果：实变型DBAC表现单叶／段实变（31％）、多叶／段实变（69％）、实变阴影内出现特征性支气管气相（77％）、泡状透亮影（54％0、毛玻璃样密度影（39％）、叶间胸膜膨出（215）。多结节型DBAC表现以两侧中下肺野为主的弥漫性腺泡结节，部分见空泡征和泡状透亮影。3例伴有母瘤，母瘤边缘有毛棘，内有空泡征。结论：实变叶／段出现下列一种CT征象提示实变型DBAC：（1）特征性支气管气相；（2）泡状透亮影；（3）磨玻璃样密度影。肺叶容积增大及动态CT变化有助于实变型DBAC的诊断。多发性肺泡征和泡状透亮影则可以诊断多结节型DBAC。母瘤的出现及其形态不表现有利于DBAC的诊断。

CT characteristic manifestations of 17 cases of diffuse bronchioaleolar carcinoma

Aim: To study the CT findings and features of diffuse bronchioaleolar carcinoma (DBAC). WTHZ Methods: WTBZ17 Cases with pathologically-proved DBAC were divded into 2 types: (1)lobar consolidation(n=13)and (2)Muti-nodular type(n=4). 13 cases with lobar pneumonia (as control group)were analyzed. WTHZ Results:WTBZ Lobar consolidation DBAC showed several lobar/segmental consolidation(9/13), on one lobar/segmental consolidation(4/13),being accompanied with characteristic air bronchogram sign (10/13), bubble-like radiolucencies(7/13), ground-glass shadow(5/13)and expanded lobar consolidations(3/13). But lobar Pneumonia didn't show these Signs. Multi-nodular DBAC Presented as diffuse nodules being located mainly in the middle and lower lung fields. Some of nodules showed bubble-like radiolucencies and Vacuole sign. Three cases with multi-nodular DBAC demonstrated maternal tumour with spiculate margins and Vacuole Sign. WTHZ Conclusion: WTBZLobar or segmental consolidations showing a findings as follow may suggest DBAC: (1)characteristic air bronchogram sign, (2)bubble-like radiolucencies, (3)ground-glass shadow. Bulged interlobar fissure and dynamic changes is helpful in dignosis for lobar consolidation DBAC. Multi-nodules being accompanied with vacuole Sign?bubble-like radiolucencies and maternal tumour with spiculate margins and vocuole sign suggest as multi-nodular DBAC.