Pandolfo I, Gaeta M, Racchiusa S, Bartiromo G, Blandino A, La Spada F, Casablanca G, Barone M
Istituto di Scienze Radiologiche, Università di Messina.
Radiol Med. 1989 Apr;77(4):342-6.
Bronchogenic carcinoma is characterized by three different patterns of spread: endobronchial, the commonest, submucosal, and peribronchial. While the diagnostic yield of bronchoscopy is very high for endobronchial masses, both submucosal and peribronchial tumors are more difficult to detect, and standard forceps biopsy can be negative. In such cases transbronchial needle aspiration biopsy allows higher diagnostic accuracy. CT findings of extramucosal neoplastic spread are not specific. Thickening of the bronchial walls is the commonest sign, but CT is inaccurate in predicting whether bronchial thickening will result in endobronchial/extramucosal neoplasm, fibrosis or bronchial wall edema. Despite this inaccuracy, CT is complementary to bronchoscopy since it allows to: 1) detect a pathology in the bronchial walls, which appear thickened; 2) delineate the extent of extraluminal spread; 3) help plan transbronchial needle aspiration biopsy.
支气管内型，这是最常见的；黏膜下型和支气管周围型。虽然支气管镜检查对支气管内肿块的诊断阳性率很高，但黏膜下和支气管周围肿瘤更难检测到，标准钳取活检可能为阴性。在这种情况下，经支气管针吸活检可提高诊断准确性。黏膜外肿瘤扩散的CT表现不具有特异性。支气管壁增厚是最常见的征象，但CT在预测支气管增厚是否会导致支气管内/黏膜外肿瘤、纤维化或支气管壁水肿方面并不准确。尽管存在这种不准确性，但CT对支气管镜检查具有补充作用，因为它能够：1）检测支气管壁增厚处的病变；2）描绘管腔外扩散的范围；3）帮助规划经支气管针吸活检。
