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目的探讨肺原发性黏液表皮样癌(MEC)的多层螺旋CT(MSCT)表现。方法回顾性分析经病理证实的24例肺原发性MEC的MSCT资料,所有患者术前均行CT平扫及增强扫描。结果本组24例均表现为单发病灶。CT平扫显示中央型17例,其中腔内息肉型14例,合并阻塞性肺炎及肺不张11例;腔内外肿块型2例,合并阻塞性肺炎及肺气肿1例,合并肺泡积血1例;管腔全层浸润型1例,增厚的管壁可见散在钙化,气道轻度狭窄。外周型7例,3例见分叶及毛刺,3例见不规则厚壁空洞。增强后轻度强化4例,中度强化11例,明显强化9例。3例合并肺门及纵隔淋巴结转移,其中1例合并骨转移。结论中央型肺MEC好发于年轻人,多表现为边缘光滑的圆形或类圆形腔内肿块,增强后中度或明显强化;而外周型MEC好发于中老年人,缺乏特征性CT表现,确诊最终依赖病理。
Objective To investigate the multi-slice spiral CT (MSCT) manifestations of primary mucoepidermoid carcinoma of the lung (MEC). Methods The MSCT data of 24 patients with pathologically confirmed primary MEC were retrospectively analyzed. All patients underwent CT scan and enhanced scan before operation. Results The group of 24 patients showed single lesions. CT showed 17 cases of central type, of which 14 cases of endoscopic polypus, with obstructive pneumonitis and atelectasis in 11 cases; intraluminal tumor mass in 2 cases, with obstructive pneumonia and emphysema in 1 case, combined with pulmonary alveolar hemorrhage 1 case; full-thickness infiltration of the lumen in 1 case, thickening of the tube wall visible scattered calcification, mild airway stenosis. Peripheral in 7 cases, 3 cases, see lobulation and burr, 3 cases, see the irregular thick-walled. Four cases were mild enhancement, 11 cases moderate enhancement, and 9 cases enhancement obviously. Three patients had hilar and mediastinal lymph node metastases, of which 1 had bone metastases. Conclusions The central pulmonary MEC is more common in young people and more often presents as a round or oval-shaped cavity with a smooth edge. It is moderately enhanced or moderately enhanced, while peripheral MEC is predominant in the elderly and lacks a characteristic CT Performance, diagnosis eventually depends on the pathology.