Abstract

目的 认识胸膜凹陷相关结节切迹(NNPI)的征象.探讨CT多平面重建(MPR)配合多层螺旋CT对恶性胸膜凹陷的诊断价值.方法 (1)观察病理证实的周围型小肺癌(SPLC)91例,良性小结节59例.9例SPLC、2例良性结节术后用改良Heitzman法充气固定肺叶制成病理大切片.比较分析良、恶性胸膜凹陷对照组及充气标本扫描和病理切片.(2)对恶性胸膜凹陷20例、良性12例行CT MPR,观察MPR显示NNPI的作用.结果 (1)NNPI是指胸膜线影进入结节内部,于结节表面形成切迹改变.此征对恶性胸膜凹陷特异度为96.5%.(2)恶性胸膜凹陷切迹在MPR的检出率为80%,与横断面扫描之间差异有显著意义(χ2=13.205,P<0.05).结论 NNPI对于恶性胸膜凹陷有高特异性诊断价值.MPR配合多层螺旋CT能提高此征检出率。

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