术中超声在中心型肺癌可切除性评估中的应用价值——与CT的对照研究

The value of intraoperative ultrasonography in judging the resectability of central bronchogenic carcinoma: a comparison with computed tomography

目的 评价术中超声 (IUS)判断中心型肺癌与肺血管关系的准确性及其对肺癌可切除性的预测作用。方法 对 30例中心型肺癌患者分别行术前增强CT和术中超声检查 ,以评分的方法对两种检查所得结果进行量化 (0～ 4分 ) ,比较两种方法在判断中心型肺癌与肺血管关系及预测肺癌可切除性方面的准确性。结果 CT和术中超声判断中心型肺癌与肺血管关系的准确率分别为 72 3% (14 1/195 )和 81 0 % (171/ 2 11) (P =0 0 37) ;预测中心型肺癌可切除性的灵敏度分别为 91 3% (2 1/ 2 3)和 95 6 % (2 2 / 2 3) ,特异度为 2 8 6 % (2 / 7)和5 7 1% (4 / 7) ,准确率为 76 7% (2 3/ 30 )和 86 7% (2 6 / 30 ) ;预测术式的准确率分别为 5 3 3% (16 / 30 )和 6 3 3% (19/ 30 ) (P =0 4 32 )。结论 术中超声在判断中心型肺癌可切除性方面有一定的临床应用价值。

Objective To evaluate the accuracy of intraoperative ultrasonography (IUS) in judging the relationship between central bronchogenic carcinoma and pulmonary vessels and in predicting the resectability of the tumor. Methods Intraoperative ultrasonograpy(IUS) and preoperative CT scanning were performed in 30 patients of central bronchogenic carcinoma. The relationship between vessel and tumor as assessed by IUS and preoperative CT were quantified and scored with a ranging from 0-4 respectively, and then the resectability of the tumor and optimal surgical method were predicted according to the scores. Results The accuracy of CT and IUS to determine tumor-vessel relationship was 72.3%(141/195) and 81.0%(171/211), respectively (P=0.037). The sensitivity of CT and IUS in predicting the resectability of tumor was 91.3%(21/23) and 95.6%(22/23), respectively, the specificity was 28.6%(2/7) and 57.1%(4/7), respectively, and the accuracy was 76.7%(23/30) and 86.7%(26/30), respectively. The accuracy of CT and IUS in predicting surgical strategy was 53.3%(16/30) and 63.3%(19/30), respectively(P=0.432). Conclusion IUS is a useful method in predicting the resectability of centrally located bronchogenic carcinoma.