多层螺旋CT评价中央型肺癌与肺动脉、上腔静脉及肺静脉的影像价值

The relationship between the central lung cancer and pulmonary artery,superior vena cava,pulmonary veins:a multislice helical CT observation

目的利用多层螺旋CT(MSCT)后处理技术,显示中央型肺癌与肺动脉、上腔静脉及肺静脉的关系。方法分析2008年1月～2010年3月经查痰及纤维支气管镜检查病理证实的40例中央型肺癌。经CT平扫加增强扫描后运用多平面重建技术(MPR)、最大密度投影(MIP)、容积再现(VR)技术等后处理方法观察肿瘤与肺动脉、上腔静脉及肺静脉的关系。结果 30例(占75%)直接侵犯肺动脉主干的管壁形成局部充盈缺损并不同程度的压迫肺动脉;5例(占12.5%)肿瘤包绕肺动脉生长,肺动脉管壁光滑无充盈缺损。3例(占7.5%)直接侵犯上腔静脉形成瘤栓;2例(占5%)肿瘤侵犯肺动脉及肺静脉形成瘤栓。结论 MSCT后处理技术可较好地显示中央型肺癌与肺动脉、上腔静脉及肺静脉的关系。结合临床病史,认真把握MSCT特点对中央型肺癌的诊断及肿块区肺血管的侵犯情况有极其重要的临床价值。

Objective To investigate the relationship between the central lung cancer and pulmonary artery,superior vena cava,pulmonary veins by multi-slice CT（MSCT）.Methods Fourty patients with central lung cancer confirmed pathologically were reconstructed by MSCT multiplanar reformation（MPR）,maximum intensity projection（MIP）,volume rendering（VR） and CT virtual endoscopy（CTVE） techniques to demonstrate the relationship between the centre lung cancer and pulmonary artery,superior vena cava,pulmonary veins.Results Tumor-PA（pulmonary artery）,superior vena cava and pulmonary veins relationship： Type Ⅰ（75%） invasion PA.Type Ⅱ（12.5%） the tumor encircle PA.Type Ⅲ（7.5%） invasion superior vena cava immediate.Type Ⅳ（5%） the tumor invasion pulmonary artery and pulmonary veins.Conclusions MSCT can demonstrate the relations among the central lung cancer and pulmonary veins,pulmonary artery and superior vena cava.16-slice CTA has great value in demonstration of supplying artery of tumour and evaluating invasion of pul-monary vessels in lung cancer.