CT仿真支气管内窥镜在中央型肺癌诊断中的应用  

CT virtual bronchoscopy in the diagnosis of central lung cancer

作　　者：Xiong Minghui ZHANG Wanshi WANG Dong 熊明辉[2] 张挽时[2] 王东[2] 宋云龙[2] 

机构地区：[1]Department of MRI, Air Force General Hospital,,北京100036 [2]解放军空军总医院磁共振科

出　　处：《中华肿瘤杂志》2001年第2期148-150,共3页Chinese Journal of Oncology

摘　　要：目的　评价螺旋CT仿真支气管内窥镜 (CTVB)在中央型肺癌诊断中的作用。方法　对45例经纤维支气管镜检查和病理证实的气管、支气管肿瘤患者进行CT仿真内窥镜检查 ,包括中央型肺癌 33例、肺癌术后 8例、肺癌放疗后 2例及气管恶性肿瘤 2例。用新型螺旋CT机对患者进行扫描后 ,将数据建成CTVB图像进行分析 ,并与纤维支气管镜进行对照 ,2 4例与病理标本进行对照。结果CTVB显示了 10 0 %的段以上支气管和 80 %以上的亚段支气管。肿瘤呈块状或结节状 ,引起管腔狭窄或闭塞。肺癌术后正常的支气管残端呈光滑的盲端 ,肿瘤复发呈结节状突出 ,与纤维支气管镜所见基本一致。肺癌放疗后支气管腔轻度凹凸不平及管腔狭窄。结论　CTVB是一种新的无创性观察气管、支气管腔的方法 ,酷似纤维支气管镜所见 ,结合其他三维重建功能 ,能同时显示管壁的厚度和肿瘤向管腔外侵犯的范围。但与纤维支气管镜相比 ,不易观察支气管黏膜的表浅病变且不能活检。Objective To evaluate the clinical application of CT virtual bronchoscopy(VB) in the diagnosis of centrally located lung cancer. Methods Fortyfive cases confirmed by fiberoptic bronchoscopy and pathology underwent volume scanning using spiral CT ( HiSpeed Advantage CT/i. GE Medical Systems, U.S.A).The patients examined included 33 with central lung cancer,8 with postoperative residual bronchial stumps,2 with postradiotherapy lung cancer, and 2 with tracheal carcinoma. Data were transferred to computer workstation(GE Advantage Windows 3.1) and CT virtual bronchoscopic (CTVB) images with pseudocolor encoding were generated using Navigator Smooth software. Results[WT5”BZ] CTVB could reveal 100% segmental bronchus and 80% subsegmental bronchus simulating fiberoptic bronchoscopy. The tumors appeared as masses or nodules, causing bronchial wall thickening and occlusions. Postoperative residual bronchial stumps showed smooth end without recurrence of tumors or appeared as nodular protrusion if tumor recurred.The postradiotherapy bronchial wall was uneven and there was narrowing of bronchial lumen. Conclusion CTVB is a noninvasive method of observing the airway. It simalates the images observed under fiberoptic bronchoscopy and com be used partly in lieu of it. Associated with multiplanar reformat,CTVB can demonstrate extraluminal invasion of the tumor. The limitations of CTVB are that it is not possible to observe mucosal abnormalities and perform biopsy.

关 键 词：中央型肺癌 诊断 CT 仿真支气管内窥镜 

分 类 号：R734.2[医药卫生—肿瘤] R734.44[医药卫生—临床医学]