Multi-detector computed tomography features of peripheral lung cancer associated with cystic airspace / 实用放射学杂志

ABSTRACT

Objective To evaluate multi-detector computed tomography(MDCT)features of lung cancer associated with cystic airspace,and to improve diagnostic accuracy.Methods 21 pathologically or clinically confirmed lung cancer associated with cystic airspace were retrospectively analyzed with regard to clinical data,pathological types and TNM stage,SUMmax and MDCT features.For dynamic follow-up CT scans,the lesion dynamic change was evaluated.Results There were 21 cases (1 1 adenocarcinoma,6 squamous carcinoma)in total. The lesion was predominant cysts in 2 cases(9.52%),cysts with GGO mixed lesions in 3 cases(14.29%),cysts with solid mixed lesions in 14 cases(66.67%),cysts with GGO and solid mixed lesions in 2 cases(9.52%).Four morphological patterns,20 cases had solid nodules,solid nodule protruding externally from the cyst wall was in 5 cases (23.81%),solid nodule protruding internally from the cyst wall was in 1 case (4.76%),solid tissue intermixed within clusters of cysts was in 14 cases(66.67%),the lesion presenting as circumferential thickening of the cyst wall was in 1 case (4.76%).The frequency of following features accounted for more than 60% of all MDCT signs,including round shape (66.67%),lobulation (80.95%),blood vessel passing through the cyst (76.1 9%),pleural indentation (80.95%);while the frequency of multiple cysts,irregular inner wall and septum in cyst in 19 lesions(90.48%)was more than 90%.With respect to the relationship between lesion and bronchus,bronchus passing through the cyst was the most common sign,accounting for 38.10%(8/21).Average CT enhancement value was 28.27 HU±7.27 HU(range 14.2-40 HU).Average SUVmax was 6.05(range 4.5-9.8),indicating marked FDG uptake.Two lesions manifested as progressive wall thickening and increased size of the cyst,and one lesion showed decreased size of the cyst and enlarged nodules in follow up CT.Conclusion The irregular inner wall,septum in cyst and blood vessel passing through the cyst are the most three important signs for the diagnosis of malignant lesions.