非小细胞肺癌血供动脉的MSCTA特征及在鉴别诊断中的价值

MSCTA features for blood supply artery of non-small cell lung cancer and its value for differential diagnosis

目的:通过多层螺旋CT血管造影(Multi-slice spiral CT angiography,MSCTA),观察非小细胞肺癌(Non-small-cell lung cancer,NSCLC)血供动脉的临床特征。方法:92例确诊的NSCLC行MSCTA血供动脉检查,并以同期行MSCTA检查、确诊为慢性肺部炎症的患者38例作为对照组。2名有经验的CT诊断医师对结果双盲法进行双盲分析。结果:92例NSCLC患者中78例(84.8%)仅见支气管动脉供血血管;9例(9.8%)仅见肺外体循环动脉供血血管;5例(5.4%)见混合型供血血管。MSCTA表现为所有肿瘤性供血动脉均不同程度增粗扭曲,走向或走行至瘤体内,瘤体区域可见杂乱无章的血管影。而慢性炎症较NSCLC更易刺激肺外体循环动脉参与供血(χ2=14.981,P=0.0001),其肺外体循环动脉供血率分别为47.4%和15.2%;慢性炎症组患者血供动脉支数和NSCLC相当(t=1.542,P=0.126);但慢性炎症组患者血供动脉的内径较NSCLC组的明显增粗(t=5.805,P=0.0001)。同时MSCTA还显示慢性炎症病灶区血管紊乱,常相互吻合形成广泛的血管网络。结论:多层螺旋CT血管造影对非小细胞肺癌血供动脉有很好的识别,可以为其介入治疗提供依据;同时慢性肺部炎症血供动脉扩张更为明显,更能刺激肺外体循环动脉参与供血,因此可以非小细胞肺癌的鉴别诊断提供参考。

Objective：To observe the clinical features ofblood supply arterial of non-small cell lung cancer（NSCLC）by the multi-slice spiral CT angiography（MSCTA）.Methods：92 patients with confirmed NSCLC conducted blood supply arterial examination by the MSCTA,38 patients with chronic lung inflammation of the same period as control group.Two experienced physicians analyzed the results though double-blind method.Results：In 92 NSCLC patients,only 78 patients（84.8%）supplied by the bronchial arteries;9 patients （9.8%）supplied by he extra-pulmonary arterial;5 patients（5.4%）supplied by mixed blood vessels.MSCTA performance for all the tumor feeding artery were distorted,and tumor area showed chaotic vascular shadow.And chronic lung inflammation were easier to have extra-pulmonary circulation arterial blood supply compared with NSCLC（χ2=14.981,P=0.000 1）,the rates were 47.4%and 15.2%, respectively;the number of blood supply arteries in patients with chronic lung inflammation and NSCLC were quite（t=1.542,P=0.126）; but the blood supply artery diameter in patients with chronic inflammation significantly thicker than that of the NSCLC group（t=5.805, P=0.000 1）.And,MSCTA also showed that vascular often coincide with each other to form a broad network in chronic lung inflammatory group.Conclusion：The multi-slice spiral CT angiography have a good identification for non-small cell lung cancer arterial blood supply, which can provide the basis for their interventional therapy;and,the blood supply arteries become more evident,more to stimulate the outside pulmonary arterial in chronic lung inflammation,so that,it can provide references for non-small cell lung cancer differential diagnosis.