肺癌肿瘤血管CTA与DSA对照及相关性

Tumor vascularity and its supplied artery in pulmonary carcinoma: CT angiography versus digital subtraction angiography

目的探讨CTA和DSA评价支气管肺癌的肿瘤血管的敏感性和相关性。方法分析93例支气管肺癌CTA及DSA图像。所有临床数据输入SPSS12.0统计分析。结果CTA与DSA检出肿瘤血管和肿瘤染色一致者87例,符合率为94.56%;CTA明显而DSA不明显者13例;DSA明显而CTAA不明显者15例;二者敏感性无明显差异,但CT未检出支气管肺动/静脉瘘。结论CTA能很好地评价肺癌供血动脉和内部血管、肿瘤染色,作为无创手段可在治疗前提供明确帮助,并避免在介入治疗中遗漏血管;但对支气管肺动/静脉瘘检出率有困难。

Objective To assess sensitivity and correlation of CT angiography (CTA) versus digital subtraction angiography (DSA) in detecting tumor vascularity and its supplied artery in pulmonary carcinoma (PLC). Methods Ninety-three patients with PLC underwent 219 vascular interventional therapies. The common and enhancement scan technique including CTA of high-speed helical CT was adopted before every treatment. The superiority arteries of PLC were observed through thoracic aortiography. Meanwhile, the corresponding pulmonary arterial angiography was held on according to tumor in lung segment. Microcatheter-inserted was used for further tumor angiography from superiority arteries. Statistics analysis was undertaken by SPSS 12.0 software. Results The coincidence of tumor vascularity and steins was 94.56% CTA and image-reconstructed versus DSA angiography. The focus with obvious evidences of tumor vascularity and stein had 13 with any evidence in DSA angiography. Conversely, the focus with obvious in DSA angiography had 15 with any evidences in CT image. Sensitivity comparison of two methods showed no statistics significances (P>0.05). But for the bronchial artery-pulmonary veins fistula (APVS) and bronchial artery-pulmonary artery fistula (APAS), CT did not detected any evidence about it. Conclusion The supplied-arterial and vascularity of PLC can be evaluated effectively by common CTA, which is very helpful to making interventional therapy regime, and effective to avoid missing blood vessel during interventional management probably leading the treatment effect decrease. The detection coincidences of APVS and APAS in CTA and image-reconstructed is much lower than that in DSA angiography.