肺癌侵犯中央肺血管及其可切除性的研究——螺旋CT血管造影与手术的相关性

Study on central pulmonary vascular involvement and resectability of lung cancer: correlation of spiral CT angiography imaging features with surgical findings

目的 评价螺旋CT血管造影 (CTA)判断肺癌侵犯中央肺血管的准确性。方法 对 33例病变在肺门区、术前诊断为肺癌的病人进行CTA检查 ,采用 5分制分析患侧中央肺血管与肿瘤的关系。盲法在术中解剖这些肺血管 ,以手术结果为标准 ,对比增强横断面CT和CTA图像判断肿瘤侵犯肺血管的准确性。结果 (1)CTA判断血管与肿瘤关系的正确率高于横断面CT(P <0 .0 0 0 1)。 (2 )CTA预测血管不能处理和不能行标准肺叶切除术的准确率高于横断面CT。结论 CTA可用于术前判断肺癌与中央肺动静脉的关系。

Objective: To evaluate the accuracy of spiral CT angiography (CTA) in judging central pulmonary vascular involvement from lung cancer. Methods: CTA was done in 33 patients who were diagnosed preoperatively as having lung cancer located in the hilum. Images of central pulmonary arteries and veins were reconstructed with curved planar reformation and multi-planar reformation. Then the relation between tumor and vessels was assessed prospectively on both axial CT and CTA images on a 5-grade scale. At surgery, that relation was blindly analyzed on a similar 5-grade scale. Results: (1) Compared with axial CT images, CTA was more accurate in judging the relation between central pulmonary vessels and tumor. And the correlation of CTA imaging features with surgical findings was much better (P<0.0001). (2) The accuracy of CTA in predicting nonresectability of lung cancer was higher than that of axial CT. Conclusion: CTA can be used in preoperative judgment of the relation between central pulmonary vessels and lung cancer.