128层螺旋CT支气管动脉造影技术用于中央型肺癌诊断的临床研究

Clinical Application of 128-slice Spiral CT Bronchial Arteriography in Diagnosis of the Central Type of Lung Cancer

目的观察128层螺旋CT支气管动脉造影技术诊断中央型肺癌的临床价值。方法选取本院2015年5月至2017年5月收治的60例中央型或隔型肺癌患者进行前瞻性研究,所有患者均予128层螺旋CT支气管动脉造影,并以支气管动脉DSA检查作为对照。比较CTA及DSA对支气管动脉的显示情况及不同管径支气管动脉的检出情况。结果 60例患者中CTA检出共46例患者为单支支气管动脉,14例患者为2支支气管动脉,共检出支气管动脉74支;DSA检出39例患者为单支支气管动脉,21例患者为2支支气管动脉,共检出支气管动脉81支。CTA对支气管动脉支数的检出率为91.36%(74/81),与DSA诊断结果之间无统计学意义(P>0.05)。CTA检出的74支支气管动脉管径在0.92~7.94mm,平均管径(2.34±0.84)mm;DSA检出的支气管动脉管径在0.61~7.85mm,平均(2.26±0.63)mm,差异无统计学意义(t=0.674,P=0.501)。在管径分布方面,CTA对1mm以上的BA管径分布情况与DSA完全相符,仅对≤1mm的支气管动脉漏诊7支,管径分布的诊断符合率为91.36%(74/81)。结论中央型肺癌存在肺动脉和支气管动脉双重供血的可能,与DSA相比,CTA对中央型肺癌的BA同样有良好显示,且可同时显示是否存在肺动脉供血,可更全面地观察肿瘤供血情况,且无创、扫描快速、操作简单,更易被患者接受,可为中央型肺癌患者的临床治疗提供可靠影像依据,值得推广。

Objective To observe the clinical value of 128-slice spiral CT bronchial artery angiography in diagnosing central lung cancer.Methods A total of Sixty patients with central or septal lung cancer admitted from May 2015 to May 2017 in our hospital were prospectively studied.All patients underwent CT angiogra phy with 128-slice spiral CT and bronchial artery DSA as control.The bronchial artery display and bronchial artery detection of different diameter cases of CTA and DSA were compared.Results A total of 46 patients were diagnosed with a single bronchial artery,and 14 patients with two bronchial arteries by CTA in 60 patients,a total of 74 bronchial arteries were detected;A total of 39 patients were diagnosed with single bronchial artery,and 21 patients with two bronchial arteries by DSA in 60 patients,a total of 81 bronchial a rteries were detected.The detection rate of bronchial artery branches was 91.36%(74/81) in CTA,which was not significantly different from DSA(P> 0.05).The diameter of74 bronchial arteries detected by CTA ranged from 0.92 to 7.94 mm,with an average of(2.34±0.84)mm.The diameter of bronchial artery detected by DSA ranged from 0.61 to 7.85 mm(2.26±0.63)mm,with no statistical difference significance(t=0.674,P=0.501).In terms of diameter distribution,the distribution of BA diameter more than 1 mm in CTA was completely consistent with DSA.Only seven bronchial a rteries missed ≤1 mm were missed,and the diagnostic coincidence rate of diameter distribution was 91.36%(74/81).Conclusion There is a possibility that central pulmonary carcinoma has dual pulmonary artery and bronchial artery blood supply.Compared with DSA,CTA has a good indication of BA in central lu ng cancer and can simultaneously show the presence of pulmona ry artery blood supply,which can provide a more comprehensive observation of tumor blood supply without invasiveness,Fast sca n ning,simple operation,easier for patients to accept,for the clinical treatment of patients with central lung cancer to provide a reliable basis for the image,it is worth promoting.