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目的：２ｃｍ以下肺内孤立病灶的良恶性鉴别诊断一直是影像诊断的难点，为了提高小肺癌诊断的准确率，我们对肺内小病灶进行了ＣＴ－病理对照研究，探讨肺内小病灶的ＣＴ征象及其对小肺癌的诊断价值；材料和方法：选择２ｃｍ以下肺内孤立小病灶进行薄层ＣＴ扫描，层厚层距均为２ｍｍ，ＣＴ机为ＴＣＴ－６００ＸＴ型，ＣＴ扫描后２周内进行手术切除，切除标本固定后；按ＣＴ扫描横断方向连续做成病理大切片。将术前ＣＴ片与病理大切片在肉眼和显微镜下进行对比研究；结果：３５例肺内小病灶中２２例为肺癌，ＣＴ正确诊断１９例，正确诊断率为８６４％，其中１４例为早期肺癌。（１）棘状突起征：有１９例，其中１８例为肺癌，１例为良性病灶，良恶性病灶有极显著差异；（２）空泡征：５例出现此征，均为肺癌；（３）血管集束征：１５例出现此征，均为肺癌；（４）ＣＴ值：２２例肺癌平均ＣＴ值为３２７Ｈｕ，良性病灶平均ＣＴ值为７５９Ｈｕ，两者差异显著，Ｐ＜００１。结论：通过ＣＴ－病理对照研究，棘突征，空泡征、血管集束征、ＣＴ值等征象对小肺癌诊断有很大价值，结合其他ＣＴ征象综合判定，能提高小肺癌诊断的准确率。
OBJECTIVE: The differential diagnosis of benign and malignant lung lesions below 2 cm in diameter is always a difficult point in imaging diagnosis. To improve the accuracy of small lung cancer diagnosis, CT-pathology control studies have been performed on small pulmonary lesions to investigate the CT of small lesions in the lungs. Signs and their diagnostic value for small lung cancer;Materials and methods:Select thin-contrast CT scans with 2 cm or less intrapulmonary lesions with a thickness of 2 mm,CT machine type TCT-600XT,within 2 weeks after CT scan. Surgical resection was performed and the resection specimens were fixed; a large pathological section was made continuously by the transverse direction of the CT scan. The preoperative CT scans were compared with macroscopic lesions under the naked eye and under the microscope. Results: Twenty-two lung lesions were diagnosed as lung cancer in 22 of 35 lung lesions, and CT was correctly diagnosed in 19 patients. The correct diagnosis rate was 86.4%, including 14 For early stage lung cancer. (1) Spinous neuritis sign: There were 19 cases, of which 18 cases were lung cancer, 1 case was benign lesions, and there were extremely significant differences between benign and malignant lesions. (2) Vacuole sign: 5 cases had this sign and all were lung cancer; 3) Vascular bundle sign: 15 cases of this sign, all lung cancer; (4) CT value: 22 cases of lung cancer, the average CT value of 32 7Hu, benign lesions mean CT value of 75 9Hu, the two significant differences, P < 001. Conclusion: CT-pathological comparative study, spinous process sign, vacuolar sign, vascular bundle sign, CT value and other signs have great value in the diagnosis of small lung cancer, combined with other CT signs comprehensive judgment, can improve the accuracy of small lung cancer diagnosis.