中央型肺癌致肺低灌注的数字减影血管造影表现初步研究  

An initial study on DSA features of pulmonary hypoperfusion second to cancerous invasion of central pulmonary artery in lung cancer

作　　者：卢武胜[1] 郭大静[2] 缪競陶[1] 刘畅[1] 胡淑雨[1] 刘文秀[1] 焦河[1] 

机构地区：[1]四川大学华西医院(原华西医科大学附属第一医院)放射科,成都610041 [2]重庆医科大学附属第二医院放射科

出　　处：《中国肺癌杂志》2001年第4期293-295,共3页Chinese Journal of Lung Cancer

摘　　要：目的　分析肺癌侵犯中央肺动脉后致肺低灌注的数字减影血管造影 (DSA)影像特征 ,探讨肺动脉受累程度与肺低灌注间的关系 ,为临床制定治疗方案提供更多的信息。方法　收集CT显示侵犯肺动脉的中央型肺癌患者 2 6例 ,行肺血管DSA检查。观察肺低灌注的DSA影像特征 ,描绘受累肺叶及健侧对应区域肺实质时间 -密度曲线 (TDC)。结果　 2 6例中 38支叶肺动脉受侵 ,34个肺叶 ( 89.5 % )出现肺低灌注。肺低灌注与肺动脉受累后狭窄程度密切相关 (P <0 .0 5 )。DSA像上肺血管征表现为肺动脉中断 ( 11.8% ,4/34 )或分支数量减少 ( 88.2 % ,30 /34 ) ,末梢肺动脉消失 ( 41.2 % ,14 /34 )或减少 ( 5 8.8% ,2 0 /34 ) ;肺实质征表现为肺组织毛细血管充盈消失 ( 14 .7% ,5 /34 )或减弱 ( 85 .3% ,2 9/34 )。结论　肺癌侵犯中央肺动脉后致该动脉供血区域出现肺低灌注 ,肺低灌注与肺动脉狭窄程度密切相关。肺实质征及肺血管征是肺低灌注的重要征象。Objective To study digital subtraction angiography (DSA) features of pulmonary hypoperfusion in lung cancer with cancerous invasion of central pulmonary artery (CICPA). Methods Twenty-six cases of lung cancer combined with CICPA underwent pulmonary DSA. The DSA features of pulmonary hypoperfusion, including pulmonary vessel signs and lung parenchyma signs, were observed, and the time-density curve(TDC) of both abnormal sides and the coordinate normal sides was drawn and analyzed. Results There were 38 lobar arteries showing cancerous invasion in 26 cases and 34 (89.5%) lobes presenting pulmonary hypoperfusion. There was a good correlation between pulmonary hypoperfusion and the degree of central pulmonary artery (CPA) stenosis (P<0.05). DSA pulmonary vessel signs included abrupt cut-off (11.8%, 4/34) or less branches (88.2%, 30/34) of pulmonary arteries, and disappearance (41.2%, 14/34) or decrease (58.8%, 20/34) of terminal pulmonary arteries. DSA lung parenchyma signs were pulmonary capillary perfusion disappearing (14.7%, 5/34) or weakening (85.3%, 29/34). Conclusion Pulmonary lobes supplied by central pulmonary arteries invaded by lung cancers usually present pulmonary hypoperfusion. Pulmonary hypoperfusion is closely correlative with the degree of CPA stenosis. Pulmonary vessel signs and lung parenchyma signs are very important phenomena of pulmonary hypoperfusion.

关 键 词：数字减影血管造影 肺低灌注 癌性侵犯 肿癌 

分 类 号：R734.2[医药卫生—肿瘤]