MRI在肺癌手术计划中的作用

The Role of MRI in Predicting Operability of Lung Cancer

目的：探讨ＭＲＩ显示与肺癌手术有关结构被侵程度的能力，制定ＭＲＩ判断肺癌能否手术的标准。方法：术前２周内均行ＭＲＩ、纤维支气管镜检查，并经手术证实为中心型肺癌病人２４例，对两种检查和手术证实结果进行回顾性对比分析。结果：ＭＲＩ显示叶支气管闭塞准确率１６／２０例，显示叶支气管狭窄准确率４／４例。病变与纵隔大血管贴邻组手术分离率７／７例，粘连组为１２／１７例，包绕组为０／４例。结论：ＭＲＩ显示叶以上支气管狭窄、阻塞可靠。病变贴邻大血管者手术容易分离；病变和大血管仅为粘连者手术均可分离，若粘连合并大血管变形、狭窄则手术分离困难；病变包绕大血管时则手术分离相当困难。

Objective:To establish a MRI criterion by which it can be judged whether operation is feasible in lung cancers.Clinical material and method:24 patients with central lung cancers were studied retrospectively MRI was confirmed with bronchoscopy preoperatively in all patients.Result:MRI accuracy rate was 16/20 in cases showing lobar bronchial obstruction,4/4 for cases showing stenosis.In MRI images,the relationship between masses and great vessels in mediastinum was classified into three types as nestling,adhering and surrounding.In nestling group,surgery was successful in 7/7.In adhering group resectability rate was 12/17.Conclusion:The higher resectability rate can be achieved in patients with MRI demonstrated nestling or moderately adhering.Severe adhesion and mass surrounding the great vessels in mediastium are not suitable for surgery.