多排螺旋CT评估胸腔肿瘤所致上腔静脉综合征的影像学分型与诊断价值  

Evaluation of image classification and diagnostic value of multislice spiral CT in superior vena cava syndrome caused by thoracic tumors

作　　者：佟佳音 郝辉[1] 李雪艳 金晨望[1] 张明[1] 郭佑民[1] TONG Jiayin;HAO Hui;LI Xueyan;JIN Chenwang;ZHANG Ming;GUO Youmin(Department of Imaging,the First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061

出　　处：《现代肿瘤医学》2021年第18期3270-3273,共4页Journal of Modern Oncology

基　　金：西安交通大学第一附属医院院内自选课题[编号:2020伦审科学第(012)]。

摘　　要：目的:探讨胸腔肿瘤所致上腔静脉综合征(SVCS)的CT增强扫描和CT血管造影(CTA)的影像学表现,评估其分型与诊断价值。方法:回顾性分析75例肿瘤引起SVCS患者的影像学表现和临床资料。结果:75例患者中行CT增强扫描62例,行CTA检查13例。肺癌所致SVCS 55例,侵袭性胸腺瘤7例,纵隔淋巴结转移瘤6例,神经内分泌癌2例,其他肿瘤5例。Stanford分型Ⅰ型27例,StanfordⅡ型18例,StanfordⅢ型17例,StanfordⅣ型13例。按梗阻部位分析,奇静脉弓上型10例,奇静脉弓型13例,奇静脉弓下型3例,混合型49例。30例患者可观察侧支循环范围和引流情况。结论:多排螺旋CT是诊断SVCS的理想手段,可判定原发病灶,并通过对梗阻部位、梗阻程度、侧支循环的识别进行影像学分型,为临床医生判断患者病情提供了更准确的信息,对下一步临床治疗提供有力依据。Objective:To investigate the contrast enhanced CT scan and CT angiography(CTA)of superior vena cava syndrome(SVCS)caused by thoracic tumors imaging findings,and to evaluate its classification and diagnostic value.Methods:Imaging findings and clinical data of 75 patients with SVCS caused by tumor were retrospectively analyzed.Results:Among the 75 patients,62 received enhanced CT scan and 13 received CTA.There were 55 cases of SVCS caused by lung cancer,7 cases of invasive thymoma,6 cases of mediastinal lymph node metastasis,2 cases of neuroendocrine carcinoma and 5 cases of other tumors.Stanford typeⅠ27 cases,Stanford typeⅡ18 cases,StanfordtypeⅢ17 cases,StanfordtypeⅣ13 cases.According to the location of obstruction,there were 10 cases of above azygos vein arch type,13 cases of arcus venae azygou type,3 cases of below azygos vein arch type and 49 cases of mixed type.30 cases can observe the scope of collateral circulation and drainage.Conclusion:Multi slice spiral CT is an ideal method for the diagnosis of SVCS.It can determine the primary lesion,and classify the image by identifying the location,degree and collateral circulation of obstruction.It provides more accurate information for clinicians to judge the patient's condition,and provides a strong basis for the next clinical treatment.

关 键 词：上腔静脉综合征 胸腔肿瘤 CT血管造影 Stanford分型 解剖分型 

分 类 号：R734.5[医药卫生—肿瘤]