螺旋CT与磁共振在肺癌分期中的应用研究

Spiral CT and MRI in staging of bronchial carcinoma

目的:探讨螺旋CT与MRI联合在肺癌分期中的应用价值。方法:36例肺癌患者,5天内同时行CT增强和MRI扫描进行TNM分期和临床分期,主要观察两者对胸部结构侵犯及肿大淋巴结的显示情况。结果:根据1997年国际肺癌分期标准,36例临床分期为ⅡA期2例、ⅡB期3例、ⅢA期9例、ⅢB期18例和Ⅳ期4例。T分期中,26例CT和MRI显示相仿,10例各有侧重,其中CT侧重显示2例邻近肋骨破坏及3例同一肺叶内其他肿瘤结节,MRI侧重显示3例胸膜外脂肪受侵及2例冠状面明确显示左心房侵犯。N分期中,CT和MRI均可显示纵隔内≥10mm的淋巴结,4例肺门淋巴结主要依靠CT判定。结论:在肺癌影像分期时,CT和MRI有较强的互补作用。

Objective： To evaluate the value of spiral CT and MRI in staging bronchial carcinoma. Methods： Thirty-six patients with bronchial carcinoma underwent both MRI and enhancement CT within 5 days. TNM staging and clinical staging were established. The invasion of thoracic structures and lymph nodes enlargement were the main observation. Results： Clinical stages and TNM stages were determined according to the international staging system, and were IIA in 2 patients, IIB in 3, IIIA in 9, IIIB in 18 and IV in 4. Among the tumor （T） stage, CT and MRI were similar in 26 cases. CT was advantageous in revealing the destruction of adjacent ribs in 2 cases and nodules in the same lung lobe in 3. MRI showed extrapleural fat invasion in 3 cases. And coronal MR images showed definite invasion of the left atrium in 2 cases. Among the node （N） stage, both CT and MR could find nodes larger than 10ram in the mediastinum. Hilar nodes in 4 cases mainly determined by CT. Conclusion： For the imaging staging bronchial carcinoma, CT and MRI can strongly support each other.