动脉CT血管造影对肺转移瘤的血供研究

Arterial CT angiography: evaluation of blood supply of pulmonary metastases

目的 用支气管动脉 (BA)和肺动脉 (PA)CT血管造影 (BA CTA和PA CTA)的方法研究肺转移瘤血供。方法 对 1 5例肺转移瘤患者分别行BA和PA数字减影血管造影 (BA DSA和PA DSA)后 ,留置导管行多层螺旋CT的PA CTA和BA CTA ,判定BA和PA对肺转移瘤的血供。结果 1 5例患者共 33个结节在BA DSA上 2 2个结节可见支气管动脉肿瘤染色 ,1 1个结节未见肿瘤血管或染色。PA DSA均未见肿瘤染色。PA CTA上肺动脉参与供血的 1 6个结节和未参与供血的 1 7个结节离胸壁最短距离差异有统计学意义 (t=3 32 ,P <0 0 5 ) ;而结节直径间差异无统计学意义 (t=1 1 3,P>0 0 5 )。BA CTA上支气管动脉参与供血的 2 7个结节和未参与供血的 6个结节离胸壁最短距离差异有统计学意义 (t=3 95 ,P <0 0 1 ) ;而结节直径间差异无统计学意义 (t=1 2 7,P >0 0 5 )。结论 BA仍是肺转移瘤的主要供血动脉 ,PA仅部分参与周围肺转移结节的血供。

Objective To evaluate the blood supply of pulmonary metastases by using bronchial arterial and pulmonary arterial multi-slice CT angiography (BA-CTA, PA-CTA).Methods PA-CTA and BA-CTA were performed on 15 patients with pulmonary metastases after digital subtraction angiography of bronchial artery and pulmonary artery (BA-DSA, PA-DSA).Blood supply of the pulmonary metastases was assessed.Results On BA-DSA, 22 nodules demonstrated diffuse tumor vessels and tumor stains while the other 11 nodules demonstrated no tumor vessels.No hypertrophic tumor vessels or tumor stains were observed within all the 33 nodules on PA-DSA.On PA-CTA, the shortest distance from the nodule to thoracic wall between 16 nodules which had been enhanced and 17 which had not been enhanced was statistically significant (t=3.32, P<0.05); but the diameter between the two groups was not statistically significant (t=1.13, P>0.05).On BA-CTA, the shortest distance from the nodule to thoracic wall between 27 nodules which had been enhanced and 6 which had not been enhanced was statistically significant (t=3.95, P<0.01); and the diameter between the two groups was still not statistically significant (t=1.27, P>0.05).Conclusion Bronchial artery was the major feeding artery to the pulmonary metastases, but in the peripheral region of the lung there was a small pulmonary components.