肺癌侵犯中央肺血管的CTA表现及病理学观察  

Spiral CT angiographic features and pathologic findings of central pulmonary vascular involvement from lung cancer

作　　者：谭群友[1] 王如文[1] 王芳泽[2] 钟定荣[2] 赵绍宏[2] 

机构地区：[1]第三军医大学附属大坪医院野战外科研究所全军胸外科中心,重庆400042 [2]解放军总医院,北京100853

出　　处：《第三军医大学学报》2002年第8期977-978,共2页Journal of Third Military Medical University

摘　　要：目的　评价螺旋CT血管造影 (CTA)判断肺癌侵犯中央肺血管的临床价值。方法　术前对 2 9例行全肺切除术的肺癌患者进行胸部CTA检查 ,分别在 3mm间隔的增强横断面CT和CTA图像上采用五分制分析患侧 187根中央肺血管与肿瘤的关系 ,术后进行病理观察。结果　肺癌侵犯中央肺动静脉有共同的影像学特征 ;以病理结果为标准 ,CTA判断血管与肿瘤关系的正确率高于横断面CT(P <0 0 1)。结论　CTA判断肺癌与中央肺血管的关系优于横断面CT。Objective To evaluate the clinical value of spiral CT angiography (CTA) in judging central pulmonary vascular involvement from hilar lung cancer. Methods CTA was done preoperatively in 29 cases of lung cancer located in the hilum. Images of 187 central pulmonary arteries and veins of these patients were reconstructed with curved planar reformation (CPR) and multiplanar reformation (MPR). The relation between tumor and vessels was assessed prospectively on both 3 mm interval axial CT and CTA images on a 5 grade scale. After pneumonectomy these vessels were dissected, and the macroscopic and microscopic findings of invasion of vessels by neoplasm on a similar 5 grade scale was blindly analyzed and compared with the corresponding axial CT and CTA appearances. Results The pathological appearances of neoplastic invasion of central pulmonary vessels had many common imaging features. And compared with axial CT images, CTA was more accurate in judging the relation between central pulmonary vessels and tumor. And the correlation of CTA imaging features with pathological patterns was better ( P <0.005). Conclusion CTA is better than axial CT in judging the relation between central pulmonary vessels and lung cancer.

关 键 词：肺癌 肺血管 肺肿瘤 肿瘤侵袭 病理学 血管造影术 X线计算机断层摄影术 

分 类 号：R734.2[医药卫生—肿瘤]