胸内淋巴结美国胸科协会分区的断层影像解剖学研究及对肺癌分期的意义

Sectional and Imaging Anatomic Classification of Intrathoracic Lymph Nodes Based on American Thoracic Society Nodal Staging System for Lung Cancer

目的 研究一种能被放射医师和临床医师共同接受的基于断层影像的ATS胸内淋巴结分区法 ,以使肺癌的CT和MRI分期简便、实用。方法 依据美国胸科协会 (ATS)淋巴结分区图 ,在 5具尸体上观察胸内淋巴结分布 ,采用 4套胸部横断层标本与 5 0例胸部CT图像对照进行横断面上的淋巴结分区。结果 用解剖学分区法对ATS分区图进行了对比、评价。在采用影像解剖标志划分的 5个胸部区段中 ,ATS分区图中各区淋巴结易于在横断层影像上识别、划分。对比分析了该断层影像分区法与肺癌分期 (AJCC ,1997)的关系及临床应用要点。结论 这种基于ATS分区图的断层影像解剖分区法将使CT和MRI对肺癌的分期更简明、实用 ,易于推广。

Objective To create an imaging based classification for intrathoracic lymph nodes would make the staging of lung cancer easier on sectional imaging and be accepted by radiologists and clinicians. Methods According to American Thoracic Society(ATS) nodal classification, the intrathoracic lymph nodes were observed on five cadavers and classified on CT scan correlated with cross sectional specimens of thorax. Results ATS nodal classification was compared and evaluated with anatomic classification, and easily translated to cross sectional imaging if thorax was divided into five segments according to anatomic landmarks on cross sectional imagings. The relations of this imaging based classification to the staging system of lung cancer(AJCC, 1997) were discussed for clinical application,and some suggestions based on sectional and imaging anatomy were put forward for how to use this classification for lung cancer staging. Conclusion This classification based on sectional and imaging anatomy would make ATS nodal classification more useful and easier for lung cancer staging on CT scan and MR imaging.