薄层CT显示支气管病变在肺癌诊断中的价值

The Value of Demonstrating Bronchial Diseases by Thin-Section CT Target Scanning in the Imaging Diagnosis of Lung Cancer

目的:探讨薄层CT靶扫描显示支气管在肺癌诊断中的作用。材料与方法:分析了137例经病理证实的支气管、肺部疾患(85例为肺癌)的正、侧位胸片和常规CT扫描资料,其中115例用加做薄层CT靶扫描的方式显示病变支气管,结果与支气管内窥镜和活检病理结果相对照。结果:薄层CT靶扫描对病变支气管的显示良好率为87％,显示不良为13％,而常规扫描则显示良好率为34％,不良者32％,还有34％未显示。结论:薄层CT靶扫描前必须仔细阅读正,侧位胸片和常规扫描图像,明确靶支气管。薄层CT靶扫描对段支气管及其邻近病变的显示可提高段支气管的中央型肺癌的诊断率,了解周围型肺癌是否累及段以上支气管,从而为临床提供更多的信息,但其定性诊断尚有限度。

Purpose: To study the role of showing pathological changes of bronchi using thin - section CT target scanning in the imaging diagnosis of lung cancer. Materials and methods: 137 cases with pathologically proved bronchopulmonary diseases which including 85 lung cancers were analysed. All these patients had chest radiographs (AP and Lteral) and also conventional chest CT scanning. The thin - section CT target scannings were made in 115 patients of this series. What shown by imaging data was compared with the pathological finding of bronchoscopic biopsy. Result: The well - define rate of diseased bronchi by thin - section CT target scanning was 87%, and that of ill - define rate was 13% . While in the conventional CT scanning, only 34% and 32% respectively, and the rest 34% of diseased bronchi even. Concluson: It is necessary that the data of the chest radiographs and the conventional CT scanning were carefully analysed to demonstrated the target bronchi before the thin - section CT target scanning was performed. The changes of pulmonary segmental bronchi and its adjacent area demonstrated by the thin - section CT target scanning are helpful to improve the diagnotic rate of cenral type of lung cancer of the segmental bronchi: and is also helpful to identify whether the pulmonary segmental bronchi have been involed by the peripheral type cancer or not, which will offer more informations for the clinic therapy but has still some limit to determining the natrue of the changes.