肺癌血管造影表现及临床意义

DSA Evaluation of Lung Cancer and the Clinical Implications

目的：研究肺癌的肿瘤血管形态，指导肺癌的诊断和介入治疗。材料和方法：对１００例肺癌病人在治疗前行支气管动脉ＤＳＡ，其中２０例同时作了肺动脉ＤＳＡ。结果：①肺癌的血供来自支气管动脉；②供血的支气管动脉增粗；③出现肿瘤血管和肿瘤染色；④少数病例可见支气管动脉与肺动脉或肺静脉直接交通；⑤纵膈或肺门淋巴结显影。表现与原发癌相似。结论：肺癌的介入治疗应选择支气管动脉为靶血管，不但要进行灌注化疗，而且要栓塞支气管动脉以阻断肿瘤的血供和异常交通，不但要栓塞原发瘤的供血动脉也要栓塞转移淋巴结的供血动脉。

Purpose: To study the tumour vessel manikstations of lung cancer in order to help the diagnosis of and the interventional therapy for the disease. Matherials and Methods: Digital subtraction angiography(DSA) of the bronchial artery was performed in 100 cases of lung cancer, of which 20 cases also underwent DSA of the pulmonary artery. Results: Lung cancer was supplied by the bronchial artery. The angiographic Findings were: 1. enlargement of the feeding bronchial arteries;2. appearance of tumour vessels and tumour stain; 3. communication of the bronchial artey with the pulmonary artery or the pulmonary vein in minority of the cases, 4. enhancement of the mediastinal or the hilar nodes,the appearances of which were the same as those of the primary tumours.Conclusion: For the interventional therapy of lung cancer, the bronchial arteries should be selected as the target vessels. Not only should chemotherapy be applied, but also the bronchial artery be embolized as well in order to eliminate tumour's blood supply and its abnormal shunt. Besides,both the arteries that supply the primary tumour and the involved nodes ought to be embolized simultaneously.