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目的 探讨细支气管肺泡癌 (BAC)的高分辨率CT征象。方法 对 2 9例BAC进行回顾性分析。分别记录结节型、多发结节型和实变型BAC的HRCT征象 ,分析有助于诊断的征象及病理基础。结果 14例结节型病灶中 86%位于肺野外周或胸膜下 ,43 %呈不规则形 ,空泡征出现率 5 1% ,磨玻璃密度 3 6% ,胸膜尾征 71% ;多发结节型的单个病灶与前者相同 ;11例实变型中磨玻璃密度、多发结节和段叶实变混合存在的 6例 ,肺段实变周围或其他肺野分布的磨玻璃密度影内伴随网格影 ,其中 1例呈“碎石路样”。结论 ①周围性结节以及伴空泡征、磨玻璃密度、胸膜尾征 4项中有 3项者高度提示结节型BAC的诊断 ;②肺段叶“蜂房样”实变并其他肺野的“碎石路样”影对弥漫性细支气管肺泡癌 (DBAC)的诊断具有特征性。③HRCT是BAC早期诊断的重要手段之一。
Objective To investigate the high-resolution CT features of bronchioloalveolar carcinoma (BAC). Methods Twenty-nine BACs were retrospectively analyzed. The HRCT signs of nodular, multiple nodular, and real-variable BAC were recorded, respectively, and the signs and pathological basis that contributed to the diagnosis were analyzed. Results Of the 14 nodular lesions, 86% were located in the periphery of the lung field or under the pleura, 43% were irregular, the incidence of vacuolar signs was 51%, the ground glass density was 36%, the pleural tail was 71%, and multiple nodules were found. The single lesion of the same type was the same as the former; in 11 cases of consolidation, the ground glass density, multiple nodules, and consolidation of the segmental leaves existed in 6 cases, and the ground glass density distribution around the consolidation segment of the lung segment or other lung fields was included in the grid. Shadow, of which 1 case was “gravel road.” Conclusion 1 There are 3 cases of peripheral nodules and accompanied by vacuolar signs, ground glass density, and pleural tails. The height of the nodule BAC is highly suggestive; 2 The “parasigmoid” consolidation of the lung segment is the same as other lung fields. The “Gravel Sample” map is characteristic of the diagnosis of diffuse bronchioloalveolar carcinoma (DBAC). 3HRCT is one of the important methods for early diagnosis of BAC.