上腔静脉综合征继发改变的CT评价

CT evaluation of secondary change of superior vena cava syndrome

目的：探讨肺癌致上腔静脉综合征（SVCS）继发改变的CT表现类型及CT价值。方法：经病理证实肺癌致SVCS51例，其中7例行上腔静脉支架植入术，回顾分析上腔静脉梗阻程度、继发改变CT表现，并作统计分析。结果：①上腔静脉梗阻程度：轻～中度18例，重度28例，完全闭塞5例；②继发改变CT表现：单纯侧枝循环建立与开放14例，单纯胸壁肿胀12例，侧支循环建立并胸壁水肿16例，两种表现均未发现9例。肺癌致SVCS时上腔静脉梗阻程度不同，胸部侧枝循环和／或胸壁水肿CT显示率不同（P〈0．05）。肺癌致SVCS时血栓形成7例。结论：胸部CT增强扫描是显示肺癌致SVCS继发改变的一种很有价值的影像学方法。

Objective：To investigate CT appearances and its value of secondary hsions of SVCS （superior vena cava syndrome） from pulmonary carcinoma.Methods：51 cases with pulmonary carcinoma resulting in SVCS confirmed by pathological examinations, of which 7 cases were placed stents in SVC （superior vena cava）, were analyzed retrospectively and statistically with emphasis on SVC obstructive extents and CF appearances of secondary lesions of SVCS.Results：（1） As for extents of SVC obstruction, slight to moderate obstruction （up to 90% stenesis ） of the SVC, marked obstruction （90% to noarly 100% stennsis） of the SVC and complete obstruction of the SVC were 18 cases, 28 cases, 5 cases in order;（2）On CT appearances of secondary lesions, cases of simple constitution and opening of collateral pathway, simph swelling of chest wall, both of the two and neither of the two were 14 cases, 12 cases, 16 cases and 9 cases in order on CT. With SVC obstruction at different extent, constitution and opening of collateral pathway and/or swelling of chest wall were different in shown ratio on CT （ P 〈 0.05）, thronbosis （or carcinomatous thrombus） was 7 cases at one end of SVC obstructive segment from pulmonary carcinoma. Conclusion： Contrast enhancement CT on chest is of great value to display of secondary lesions of SVCS from pulmonary carcinoma.