支气管黏液表皮样癌CT分析
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摘要
目的:探讨并总结支气管黏液表皮样癌(mucoepidermoid carcinoma,MEC)的CT表现,提高影像学诊断的准确率。方法:回顾性分析漯河医学高等专科学校第二附属医院2015年8月—2017年10月经病理学检查证实的12例支气管MEC患者,归纳并总结其影像学表现,并与病理学检查结果进行对比。结果:12例患者表现为咳嗽、咳痰、咯血及胸闷,其中2例肿瘤位于气管,3例位于主支气管,6例位于段支气管,1例位于右侧中间支气管。平扫均为等或稍低密度,4例可见钙化,增强扫描为中度-明显强化,3例强化不均匀。结论:支气管MEC的CT表现有一定的特征性,多层螺旋CT(multislice spiral CT,MSCT)平扫加增强结合多平面重建(multi-planar reformation,MPR)可显著提高其诊断准确率。
Objective: To investigate and summarize the CT features of bronchial mucoepidermoid carcinoma(MEC) to improve the diagnostic accuracy of imaging. Methods: The CT data of twelve MEC patients confirmed by pathology from Aug. 2015 to Oct.2017 in The Second Affiliated Hospital of Luohe Medical College were retrospectively analyzed and compared with pathological results. Results: Twelve patients presented with cough, expectoration, hemoptysis and chest tightness. Among them, two lesions were located in the trachea, three in the main bronchus, six in the segmental bronchus, and one in the right middle bronchus. Plain scan showed isodensity or slightly low density. Calcifications were seen in four cases. Enhanced scan showed medium to obvious enhancement, and three cases had inhomogeneous enhancement. Conclusion: CT findings of bronchial mucoepidermoid carcinoma have certain characteristics. Multi-slice spiral CT(MSCT) scan plus enhanced scan and multi-planar reconstruction(MPR) can significantly improve the diagnostic accuracy.
Objective: To investigate and summarize the CT features of bronchial mucoepidermoid carcinoma(MEC) to improve the diagnostic accuracy of imaging. Methods: The CT data of twelve MEC patients confirmed by pathology from Aug. 2015 to Oct.2017 in The Second Affiliated Hospital of Luohe Medical College were retrospectively analyzed and compared with pathological results. Results: Twelve patients presented with cough, expectoration, hemoptysis and chest tightness. Among them, two lesions were located in the trachea, three in the main bronchus, six in the segmental bronchus, and one in the right middle bronchus. Plain scan showed isodensity or slightly low density. Calcifications were seen in four cases. Enhanced scan showed medium to obvious enhancement, and three cases had inhomogeneous enhancement. Conclusion: CT findings of bronchial mucoepidermoid carcinoma have certain characteristics. Multi-slice spiral CT(MSCT) scan plus enhanced scan and multi-planar reconstruction(MPR) can significantly improve the diagnostic accuracy.
引文
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[2]PARKCM,GOOJM,LEEHJ,etal.Tumorsinthe tracheobronchial tree:CT and FDG PET features[J].RadioGraphics, 2009, 29(1):55-71.
[3]PAPIASHVILLI M, ATER D, MANDELBERG A, et al. Primary mucoepidermoid carcinoma of the trachea in a child[J].Interact Cardiovasc Thorac Surg, 2012, 15(2):311-312.
[4]SMETANA H F, IVERSON L, SWAN L L. Bronchogenic carcinoma:an analysis of 100 autopsy cases[J]. Mil Surg,1952, 111(5):335-351.
[5]MOLINA J R, AUBRY M C, LEWIS J E, et al. Primary salivary gland-type lung cancer:spectrum of clinical presentation,histopathologic and prognostic factors[J]. Cancer, 2007,110(10):2253-2259.
[6]江森,朱晓华,孙兮文,等.气管、支气管黏液表皮样癌的多层螺旋CT表现[J].临床放射学杂志, 2006, 25(3):225-228.
[7]YOUSEM S A, HOCHHOLZER L. Mucoepidermoid tumors of the lung[J]. Cancer, 1987, 60(6):1346-1352.
[8]肖彪.支气管黏液表皮样癌9例[J].中华外科杂志,2001, 39(9):693.
[9]林敏芳,杨之怡,张宏英.支气管黏液表皮样癌96例临床分析[J].实用肿瘤学杂志, 2006, 20(2):129-130.
[10]刘志敏,宋蕾,于彤,等.儿童支气管黏液表皮样癌的CT表现[J].医学影像学杂志, 2018, 28(1):43-46.
[11]陈辉,余建群,徐忠孜,等.原发性肺黏液表皮样癌的多排螺旋CT表现与病理对照研究[J].临床放射学杂志, 2014,33(5):702-706.
[12]MEISINGER Q C, KLEIN J S, BUTNOR K J, et al. CT features of peripheral pulmonary carcinoid tumors[J]. AJR Am J Roentgenol, 2011, 197(5):1073-1080.
[13]雷强,余煜栋,包盈莹.原发性气管主支气管低度恶性肿瘤的CT及PET/CT表现[J].放射学实践, 2017, 32(11):1137-1140.