約2年以上の経過が追跡可能であった肺腺癌の初回CT画像所見の検討  [in Japanese] The Initial Appearance of Lung Adenocarcinoma on Computed Tomography  [in Japanese]

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Abstract

目的・方法. 外科的に切除された肺腺癌で,過去約2年以上の経過がCT画像で追跡可能であった17症例について,肺癌と認識しうる初回のCT画像所見(初回CT像)および画像の経時的変化に関する検討を行った.結果. 初回CT像は,(1)淡い濃度上昇が主体のすりガラス(ground-glass opacity,以下GGO)様陰影,(2)内部に複数の細気管支透亮像を有する浸潤影(bubble-like appearance,以下BLA)様陰影,(3)孤立性小結節(以下nodule)様陰影,(4)瘢痕(以下scar)様陰影,の4所見に分類された.病変陰影への血管の関与,内部の気管支透亮像,胸膜陥入の所見はいずれも,初回CT像に比較して術前CT画像で認められる頻度が増加していた.血管の関与は,初回CT像で,他の所見に比較し最も高頻度に認められた.GG0様陰影では,経過中に内部に濃度上昇域が出現し,その後陰影が増大する症例を認めた.病変陰影の最大径の増大様式は,(1)緩徐な増大,(2)急速な増大,(3)初期は緩徐で後に増大速度が増加,の3様式に分類可能であった.増大様式やdoubling timeの検討により,GG0・BLA様陰影は6〜12ケ月,nodule様陰影は2〜3ケ月の経過観察期間が適切であると推察された.結論. 肺腺癌は初回CT像により,病変径の増大様式やdoubling timeに特徴を認めることが示された.

Objective. To determine the initial appearance of lung adenocarcinoma on computed tomography and the appropriate follow-up duration. Study Design. Retrospective review of 17 cases in which computed tomography (CT) of the chest was performed about 2 years prior to the diagnosis of lung cancer. The diagnosis was confirmed by surgical resection in all cases. Result. The lung cancers were divided into four types based on their appearance on the initial CT: 1. Ground-glass opacity (GGO) -like images in which the lesion appeared as a faint opacity, 2. BLA (bubble-like appearance) image, in which the lesion resembled a focal collection of air, 3. A small solitary nodule, and 4. A scar-like image. Vascular involvement, air-bronchogram, and pleural indentation were all more prominent during a serial scan obtained just prior to surgery than on the initial scan. An increase in vascular involvement occurred prior to the other changes. High attenuation areas appeared in the GGO-like lesions prior to an increase in the size of the lesion. The growth pattern was classified as slow growing, rapidly growing, and initially slow growing with accelerated growth. The doubling time was similar in lesions with the same appearance. This information can be used to guide follow-up of images suspected of lung cancer. The appropriate follow-up duration is estimated from 6 to 12 months for GGO and BLA-like images, and from 2 to 3 months for small solitary nodules. Conclusion. The biological behavior of lung cancer is reflected in their initial appearance on CT.

Journal

  • Japanese Journal of Lung Cancer

    Japanese Journal of Lung Cancer 42(6), 573-581, 2002-10-20

    The Japan Lung Cancer Society

References:  15

Cited by:  7

Codes

  • NII Article ID (NAID)
    110003137928
  • NII NACSIS-CAT ID (NCID)
    AN00203978
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869628
  • Data Source
    CJP  CJPref  NII-ELS 
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