肺癌的肿瘤分期及ct影像学表现课件_1

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1、肺癌的肿瘤分期及CT影像学表现南方医科大学第一临床医学院T1T1:Atumorlessthanorequalto3cmingreatestdimension,surroundedbylungorvisceralpleura,withoutbronchoscopicevidenceofinvasionmoreproximalthanthelobarbronchus(i.e.,notinthemainbronchus).T1Example1:ThisisanexampleofarightlungT1lesion(inthiscaseanadeno

2、carcinoma).Thetumormeasures2.4cminsizeandiscompletelysurroundedbylung.T1Example2:ThisisanexampleofaT1lesionintheleftlung(thenodulardensityintherightlunganteriorly[bluearrow]istheinferiormarginoftherightclavicularhead).Thetumormeasures1.8cminsizeandiscompletelysurroundedbylu

3、ng.Athinlineardensityradiatestothepleuralsurfacefromthelesion-thisisreferredtoasa"pleuraltag"whichisfelttorepresenttumor-inducedthickeningoftheinterlobularsepta.Thereisafocaltriangular-shapedpleural-baseddensityidentifiedattheinsertionofthe"pleuraltag"(blackarrow).Thisfindi

4、ngisfelttobesecondarytothedesmoplasticreactionincitedbythetumor.Thereisretractionofthevisceralpleuratowardsthelesion,andasmallquantityoffluidcollectswithinthespaceformedbetweenthevisceralandparietalpleuraproducingthefindingidentifiedoncomputedtomography.Thefindingdoesnotind

5、icatevisceralpleuralinvasion.T2T2:Atumorwithanyofthefollowingfeatures:i)Largerthan3cminlargestdimensionii)Associatedwithatelectasisorpost-obstructivepneumonitisthatextendstothehilarregion,butdoesnotinvolvetheentirelungiii)InvadesthevisceralpleuraT2i)Largerthan3cminlargestdi

6、mensionThislargesquamouscellcarcinomameasures5.4cmintransversedimension.Lineardensitiesradiatetothepleuralsurfacefromthelesion.Thereisafocalpleural-baseddensityidentifiedlaterally(bluearrow),buttheunderlyingsubpleuralfatisnotdisrupted.Thisfindingislikelyduetothedesmoplastic

7、reactionincitedbythetumor.Aspreviouslydiscussed,retractionofthevisceralpleuratowardsthelesionpermitsthedevelopmentofapotentialspacebetweenthevisceralandparietalpleura.Asmallquantityoffluidwithinthespacecanproduceasoft-tissueopacitybetweenthelesionandthepleuralsurface.T2ii)A

8、ssociatedwithatelectasisorpost-obstructivepneumonitisthatextendstothehilarregion,b