MSCT评价中央型肺癌侵犯纵隔血管的临床价值  

Clinical Value of Multi--slice Spiral CT in Evaluation of the Mediastinal Vascular Involvement by Central Lung Cancer

作　　者：热娜古力[1] 刘文亚[1] 木合拜提·买合苏提[1] 王海涛[1] 党军[1] 孙亚菁[1] 

机构地区：[1]新疆医科大学第一附属医院影像中心,新疆乌鲁木齐830054

出　　处：《实用放射学杂志》2010年第9期1266-1269,1276,共5页Journal of Practical Radiology

摘　　要：目的 分析中央型肺癌侵犯纵隔、肺门大血管的MSCT征象.方法 收集101例经病理、手术证实中央型肺癌患者的资料,此前均行MSCT增强扫描,结合常规增强横断面图像及后处理重建图像,分析中央型肺癌侵犯邻近血管的影像学特征.结果 中央型肺癌侵犯肺动脉有以下3种征象：＂手握球征＂、＂枯树征＂、＂残根征＂.不同病理类型的肺癌侵犯肺动脉CT征象不同,＂手握球征＂多见于鳞癌（占88.89%）,＂枯树征＂多见于小细胞肺癌（占85.71%）,不同病理类型肺癌侵犯肺静脉CT征象无明显差异（P〉0.05）.发生在右侧的中央型肺癌中上腔静脉受侵多见于小细胞肺癌（占71.43%）且CT征象均为管腔狭窄或包埋截断.结论 MSCT增强扫描及图像后处理技术能客观地判断中心型肺癌侵犯血管的影像特征,从而可以为临床制订肺癌的治疗方案提供客观依据.Objective To analyse multi--slice spiral CT（MSCT） features of the involvement of mediastinum and central pulmonary vessels by central lung cancer（CLC）. Methods 101 with CLC confirmed by pathology and operation underwent plain CT and contrast--enhanced CT scan. CT findings of the involvement of mediastinum and large pulmonary vessels by CLC were analysed combined with CT post--processing images. Results There were three signs of the involvement of the central pulmonary artery by CLC： hand--grasping--ball sign, which mostly seen in squamous cell carcinoma（ 88.89 %） , withered--branch sign, which mostly seen in small cell carcinoma （85.71 %） and truncated root sign. But there was not statistical significance（P〉0.05） between these three CT signs in different pathological types of CLC. The involvement of superior vena cava（SVC） by right CLC was mostly seen in small cell carcinoma,the CT findings included narrowing of SVC and SVC encapsulated by tumor. Conclusion MSCT scan and the post-- processing technique can display the anatomical features of the mediastinal and central pulmonary vascular involvement by CLC, which is helpful for clinical administration.

关 键 词：肺 肺癌 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]