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目的 探讨细支气管腺瘤（BA）的临床及CT表现，提高对BA的诊断准确率。方法 回顾性分析24例经病理证实的28个BA病灶的临床资料及CT表现。结果 24例患者共28个病灶，女15例，男9例，平均（62.5±11.5）岁。21例均无临床症状，其中有12例（占50%）患者伴发其他性质的肺结节。28个结节在右肺下叶分布最多（10个），其次右肺上叶（9个）、左肺下叶（4个）、左肺上叶（3个），右肺中叶分布最少（2个）；绝大多数结节位于胸膜下区（27个），仅1个位于叶间区域。本组共28个肺结节，其中磨玻璃结节9个、实性结节14个、部分实性结节5个，三组CT值分别为（-522.44±120.93）HU、（-53.79±181.27）HU、（-339.00±169.32）HU，三组间密度差异有显著统计学差异（H=18.88,P<0.001），两两比较差异均有统计学意义（均P<0.05）。三组最大长径分别为（11.44±6.14）mm、（5.40±2.24）mm、（6.24±2.98）mm；三组整体长径差异有统计学意义（H=8.726,P=0.0127），其中磨玻璃结节长径显著大于实性结节（P=0.0054），其余组间长径差异无统计学意义。结节整体边界清晰占比高（21个，占75%）；异常血管征20个（占71.4%），毛刺征13个（占46.4%），分叶征12个（占42.9%），空泡征10个（占35.7%），异常空气支气管征2个（占7.1%）。结论 BA以中老年女性偶发，多无症状，CT表现多为胸膜下区各类型肺结节，异常血管征是最常见征象。
Abstract：Objective To investigate the clinical and CT features of bronchiolar adenoma(BA) for diagnosing this rare pulmonary neoplasm. Methods The clinical data and CT appearance of 28 pathologically confirmed BA lesions from 24 patients[15 women, 9 men; mean age:(62.5±11.5) years]were retrospectively analyzed. Results Of 24 patients, 21(87.5%) were asymptomatic.Concurrent pulmonary nodules of other histologic types were observed in 12 patients(50%). The majority of nodules(27/28,96.4%) were subpleural with only 1/28 interlobar nodule. The right lower lobe was the most frequent location(10), followed by the right upper lobe(9), left lower lobe(4), left upper lobe(3), and right middle lobe(2). The mean CT values were(-522.44 ±120.93) HU for 9 ground glass nodules(GGNs),(-53.79±181.27) HU for 14 solid nodules, and(-339.00±169.32) HU for 5 part-solid nodules with significant difference among the three groups using Kruskal-Wallis H test(H=18.88, P<0.001), and between all groups by pairwise comparisons(all P<0.05). The maximum diameters of GGNs[(11.44±6.14) mm]were significantly(P=0.0054) larger than that of solid nodules[(5.40±2.24) mm]whereas the differences were not significant between GGNs and part-solid nodules[(6.24 ±2.98) mm]or between solid and part-solid nodules. Well-defined margins were observed in 21 nodules(75%). The abnormal vessel sign was the most common feature, seen in 20 nodules(71.4%), followed by spiculation in 13(46.4%), lobulation in 12(42.9%), vacuole sign in 10(35.7%), and abnormal air bronchogram in 2(7.1%) nodules. Conclusion BA is often an incidental finding in middle-aged and elderly women, with the majority of patients being asymptomatic. CT typically shows various types of pulmonary nodules located in the subpleural region. The abnormal vessel sign is the most frequent CT feature.
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基本信息:
中图分类号:R734.2;R730.44
引用信息:
[1]冯炜,赵博峰,陈平,等.肺细支气管腺瘤CT表现并文献复习[J].影像诊断与介入放射学,2026,35(02):91-98.
2026-04-25
2026-04-25