血管侵犯的多排螺旋CT征象对小细胞肺癌的临床价值

Clinical Value of MSCT Findings of Vascular Invasion in Small Cell Lung Cancer

目的分析小细胞肺癌(SCLC)血管侵犯的CT征象特点。方法回顾性分析50例经术后病理证实为SCLC的CT增强表现,重点分析SCLC累及血管的情况,并按血管受侵犯程度的不同分为3个等级,最后进行统计分析。结果50例中,血管受累及的42例共84支血管,未见明显受累及的8例;其中肺动脉受累及37支,肺静脉受累及29支,上腔静脉受累及16支,主动脉受累及2支;按血管受累及程度,1级12支,2级3支,3级69支。出现"冰冻纵隔"征象的8例。早期发生远处转移的11例。结论SCLC对大血管的侵犯是其特征性的CT征象,大血管受侵犯程度的差异分析对SCLC性质、分期的确定以及治疗、预后等方面都具有重要的临床意义。

Objective To analyze the CT features of vascular invasion in small cell lung cancer. Methods Enhanced CT performance of 50 cases confirmed for small cell lung cancer by postoperative pathology was retrospectively analyzed,focusing on the vascular invasion in small cell lung cancer,and creating three different levels according to the degree of vascular invasion,then finally making a statistical analysis. Results In the 50 cases,42 cases had vascular invasion,and 8 cases had no significant invasion. Among them,37 cases had pulmonary artery invasion,29 cases had pulmonary vein invasion,16 cases had superior vena cava invasion,16 cases had aortic invasion,and 2 cases had aortic invasion. According to the degree of vascular invasion,there were 12 cases in grade 1,3 cases in grade 2,and 69 cases in grade 3. There were 8 cases with "frozen mediastinum" sign. There were 11 cases with distant metastasis in the early stage. Conclusion The vascular invasion in small cell lung cancer is a characteristic CT finding,whose analysis has important clinical significance for the diagnosis,staging as well as treatment,prognosis of small cell lung cancer.