周围型肺癌与肺动静脉和支气管关系的螺旋CT表现  

The relationship between the peripheral lung cancer and the bronchi, pulmonary artery and vein： a multislice helical CT observation

作　　者：柳学国[1] 王勇[3] 梁明柱[1] 张皓[4] 陈翠芬[1] 秦培鑫[1] 钟国梅[1] 何燕丽[1] 刘晓彬[1] 韩铭钧[1] 易先平[2] 

机构地区：[1]中山大学附属第五医院放射科,珠海519000 [2]中山大学附属第五医院病理科,珠海519000 [3]厦门大学附属中山医院影像科 [4]兰州医学院附属第一医院放射科

出　　处：《中华放射学杂志》2008年第6期592-596,共5页Chinese Journal of Radiology

摘　　要：目的利用多层螺旋CT（MSCT）后处理技术，显示并分析周围型肺癌与支气管、肺动脉、肺静脉的影像表现及相关因素。方法搜集54例经外科手术病理证实的周围型肺癌，CT增强扫描后运用多平面重组、最大密度投影等后处理方法观察肿瘤与肺动静脉、支气管间的关系并分型（1型：在肿瘤边缘被截断；2型：在肿瘤内部截断；3型：在肿瘤内部穿过；4型：在肿瘤边缘走行．僵直、牵拉或变窄；5型：在肿瘤边缘走行，向外推压呈光滑弧形）。使用χ^2检验和相关性分析，统计分型与周围型肺癌病理类型、分期、大小、部位和密度之间的关系。结果（1）支气管分型中：1型（33例，61．1％）多见于直径2．0cm以上、实性、Ⅱ～Ⅳ期周围型肺癌；2型（14例，25．9％）多见于直径2cm以下、部分实性或非实性，Ⅰ期周围型肺癌。（2）肺动脉分型中：1、2、4型比例相近（15例，27．8％；25例，46．3％；11例，20．4％），1型多见于直径2．0cm以上、实性、Ⅱ～Ⅳ期周围型肺癌，2型多见于部分实性或非实性、I期周围型肺癌。（3）肺静脉分型中：4型最多见（29例，53．7％），2型（13例，24．1％）多见于部分实性或非实性肺癌。（4）支气管、肺动脉受累分型间呈正相关（r=0．5265，P〈0．01）。结论MSCT后处理技术可显示周围型肺癌时支气管、肺动静脉的影像改变类型，为后续良恶性鉴别或长期预后等相关研究打下基础。Objective To investigate the relationships between the peripheral lung cancer and pulmonary vessels or bronchi by 16-row multislice computed tomography （MSCT） and analyze the related factors. Methods Fifty-four patients with peripheral lung cancer confirmed pathologically underwent contrast-enhanced MSCT. Multiplanar reformation （MPR） and maximum intensity projection （MIP） in all patients were used to demonstrate the relationships between the peripheral lung cancer and pulmonary vessels, bronchi. The relationships were categorized five types： Type 1, erupted at the edge of nodule. Type 2, erupted at the center of nodule. Type 3, penetrated through the nodule. Type 4, contacting the nodule but stretched or encased. Type 5, contacting the nodule but smoothly compressed. The pathology type, stage, size, density and location of the peripheral lung cancer were recorded and the relationships with five types were evaluated by using Chi-square test and correlation analysis. Results （ 1 ） Tumor-bronchi relationship： type 1 （33,61.1%） was more often seen in Ⅰ〉2.0 cm and solid lesions with stage Ⅱ--Ⅳ, while Type 2（ 14,25. 9% ） was often seen in 〈2. 0 cm and part-solid or non-solid lesions with stage I. （2） Tumor-PA relationship： Type 1 was more often seen in I〉2.0 cm and solid lesions with stage Ⅱ--Ⅳ, while Type 2 was often seen in part-solid or non-solid lesions with stage Ⅰ. （3） Tumor-PV relationship： type 4 was the most common type （29,53.7%）. Type 2 （ 13,24. 1% ） was more often seen in part-solid or non-solid lesions. （4） Tumor-bronchi relationship and tumor-PA relationship had a positive correlation （r = 0. 5265,P 〈 0. 01 ）. Conclusions MSCT can demonstrate the relations between the peripheral lung cancer and bronchi, PA and PV. It is useful for the differential diagnosis and prognosis evaluation of the lung cancer.

关 键 词：肺肿瘤 肺动脉 肺静脉 支气管 体层摄影术 X线计算机 

分 类 号：R686[医药卫生—骨科学]