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目的:探讨小细胞肺癌(SCLC)CT影像学表现。方法:搜集经病理证实的SCLC病例临床及胸部CT资料,统计分析SCLC的CT影像学表现。结果:164例中男性134例、女性30例,平均年龄(60.2±10.4)岁。病灶大小9-123mm,平均(46.0±18.3)mm。病灶密度均匀119例(72.6%),钙化3例(1.8%)。平扫CT平均值(37.4±5.1)Hu,增强后平均增加(18.8±5.6)Hu。出现淋巴结肿大144例(87.8%)。病灶单侧积液39例(23.8%),双侧胸腔积液2例(1.2%),心包积液17例(10.4%),心包并胸腔积液13例(7.9%)。中央型肺癌121例(73.8%),合并肺不张44例(36.4%),胸膜转移3例(2.5%)。周围型肺癌43例(26.2%),形状类圆形40例(93.0%),边缘光滑37例(86.0%),分叶征31例(72.1%),血管聚束征15例(34.9%),磨玻璃征11例(25.6%),毛刺征5例(11.6%),胸膜凹陷征3例(7.0%),空泡征2例(4.7%),胸膜转移14例(32.6%)。结论:肺内病灶早期出现淋巴结肿大及远处转移时要考虑SCLC的可能。密度均匀、边缘光滑、轻中度强化是周围型SCLC最主要影像学表现。最终确诊依赖临床病理。
Objective: To investigate the CT findings of small cell lung cancer (SCLC). Methods: The clinical and chest CT data of pathologically confirmed cases of SCLC were collected, and CT imaging findings of SCLC were statistically analyzed. Results: There were 134 males and 30 females in 164 cases, the average age was (60.2 ± 10.4) years old. The size of the lesion was 9-123 mm, with an average of (46.0 ± 18.3) mm. The lesions were evenly distributed in 119 cases (72.6%) and calcified in 3 cases (1.8%). The mean CT scan was (37.4 ± 5.1) Hu, and the average enhancement was (18.8 ± 5.6) Hu. There were 144 cases of lymphadenopathy (87.8%). Thirty-nine patients (23.8%) had unilateral effusion, 2 patients (1.2%) had bilateral pleural effusion, 17 patients (10.4%) had pericardial effusion, and 13 patients (7.9%) had pericardial and pleural effusion. Central-type lung cancer in 121 cases (73.8%), combined atelectasis in 44 cases (36.4%), pleural metastasis in 3 cases (2.5%). There were 43 cases (26.2%) of peripheral lung cancer, 40 cases (93.0%) with circular shape, 37 cases (86.0%) with smooth margin, 31 cases (72.1% (20.6%), glitchy sign in 5 (11.6%), pleurodesis in 3 (7.0%), vacuolization in 2 (4.7%) and pleural metastasis in 14 (32.6%). Conclusions: The possibility of SCLC should be considered in the early stage of pulmonary lesions with lymphadenopathy and distant metastasis. Uniform density, smooth edges, mild to moderate enhancement is the most important peripheral imaging imaging SCLC. The final diagnosis depends on clinical pathology.