目的:探讨进行肺动脉CT血管造影(CTA)检查时对比剂注射速率的不同对上腔静脉伪影的影响。方法:选择在昆明医科大学第五附属医院进行肺动脉CTA检查的60例患者作为研究对象。将其随机分为A组与B组。进行肺动脉CTA检查时,用单筒注射器分别...目的:探讨进行肺动脉CT血管造影(CTA)检查时对比剂注射速率的不同对上腔静脉伪影的影响。方法:选择在昆明医科大学第五附属医院进行肺动脉CTA检查的60例患者作为研究对象。将其随机分为A组与B组。进行肺动脉CTA检查时,用单筒注射器分别以3.5 m L/s、4.5 m L/s的速率为A组患者、B组患者注射对比剂碘海醇50 m L,然后采用自动触发跟踪扫描技术进行图像采集,并对图像进行后处理分析及质量评价。结果:A组患者上腔静脉及右肺动脉干的CT值均低于B组患者,P<0.05。两组患者肺动脉CTA图像质量的评分均≥2分,均能满足临床诊断的需要。两组患者肺动脉CTA图像质量的评分相比,P>0.05。与B组患者相比,A组患者中CTA图像质量评分为4分患者的占比更高,P<0.05。结论:进行肺动脉CTA检查时,用单筒注射器以低速率和高速率注射对比剂均能获得较高质量的CTA图像。在保证CTA图像质量满足临床诊断需要的前提下,用单筒注射器以低速率注射对比剂能在一定程度上降低CT值,减少上腔静脉内因注入高浓度对比剂而产生的线束硬化伪影。展开更多
Background IIIb-T4 non-small cell lung cancer （NSCLC） is commonly considered a contraindication to surgery, although chemo-radiotherapy also achieves a poor survival rate. We reviewed our experience with T4 NSCLC pa...Background IIIb-T4 non-small cell lung cancer （NSCLC） is commonly considered a contraindication to surgery, although chemo-radiotherapy also achieves a poor survival rate. We reviewed our experience with T4 NSCLC patients who underwent surgery to explore the indications and prognostic factors of surgical treatment of lung cancer invading the left atrium and great vessels. Methods We investigated a cohort of 105 patients, 79 men and 26 women, who underwent surgery from May 1996 to July 2008. Their pathological staging was T4No-2M0. The median age was 59 years, ranging from 36 to 75 years. Patients were grouped based on invading sites： tumors invading the left atrium （LA group）, tumors invading the superior vena cava （SVC group）, and tumors invading the intrapericardial pulmonary artery （PA group）. Patients were further characterized based upon the type of operation, complete resection and incomplete resection groups, and on the lymph node pathological status, No, N1 and N2 groups. We calculated the overall five-year survival rate. Results All patients received resection of primary lesions, with partial resection of the left atrium in the LA group （n=-25）, angioplasty of superior vena cava in the SVC group （n=-23） and intrapericardial ligation of the pulmonary artery in the PA group （n=57）. Complete resection was possible in 77 patients （73.3%）. The overall survival rate of the 105 patients was 41.0% at 5 years; 36.0% for the LA group, 34.8% for the SVC group and 45.6% for the PA group. Pathological N status significantly influenced the overall 5-year survival rate; 61.5% for No, 51.1% for the N1 and 11.8% for the N2 groups （N2 group versus No group, P 〈0.0001, N2 versus N1 group, P〈0.0001）. Surgical resection also influenced survival; 49.4% for the complete resection group and 17.9% for the incomplete resection group （P 〈0.0001）. Cox regression analysis demonstrated that pathological N status was a significant independent predictor of prognosis. Conclusions Pathological N status is a significant independent predictor for survival of patients with IIIb-T4 lung cancer invading the left atrium and great vessels. The completeness of resection has a significant influence on the overall 5-year survival rate. Surgery for T4 lung cancer may be effective in patients without mediastinal lymph node involvement.展开更多
文摘目的:探讨进行肺动脉CT血管造影(CTA)检查时对比剂注射速率的不同对上腔静脉伪影的影响。方法:选择在昆明医科大学第五附属医院进行肺动脉CTA检查的60例患者作为研究对象。将其随机分为A组与B组。进行肺动脉CTA检查时,用单筒注射器分别以3.5 m L/s、4.5 m L/s的速率为A组患者、B组患者注射对比剂碘海醇50 m L,然后采用自动触发跟踪扫描技术进行图像采集,并对图像进行后处理分析及质量评价。结果:A组患者上腔静脉及右肺动脉干的CT值均低于B组患者,P<0.05。两组患者肺动脉CTA图像质量的评分均≥2分,均能满足临床诊断的需要。两组患者肺动脉CTA图像质量的评分相比,P>0.05。与B组患者相比,A组患者中CTA图像质量评分为4分患者的占比更高,P<0.05。结论:进行肺动脉CTA检查时,用单筒注射器以低速率和高速率注射对比剂均能获得较高质量的CTA图像。在保证CTA图像质量满足临床诊断需要的前提下,用单筒注射器以低速率注射对比剂能在一定程度上降低CT值,减少上腔静脉内因注入高浓度对比剂而产生的线束硬化伪影。
文摘Background IIIb-T4 non-small cell lung cancer （NSCLC） is commonly considered a contraindication to surgery, although chemo-radiotherapy also achieves a poor survival rate. We reviewed our experience with T4 NSCLC patients who underwent surgery to explore the indications and prognostic factors of surgical treatment of lung cancer invading the left atrium and great vessels. Methods We investigated a cohort of 105 patients, 79 men and 26 women, who underwent surgery from May 1996 to July 2008. Their pathological staging was T4No-2M0. The median age was 59 years, ranging from 36 to 75 years. Patients were grouped based on invading sites： tumors invading the left atrium （LA group）, tumors invading the superior vena cava （SVC group）, and tumors invading the intrapericardial pulmonary artery （PA group）. Patients were further characterized based upon the type of operation, complete resection and incomplete resection groups, and on the lymph node pathological status, No, N1 and N2 groups. We calculated the overall five-year survival rate. Results All patients received resection of primary lesions, with partial resection of the left atrium in the LA group （n=-25）, angioplasty of superior vena cava in the SVC group （n=-23） and intrapericardial ligation of the pulmonary artery in the PA group （n=57）. Complete resection was possible in 77 patients （73.3%）. The overall survival rate of the 105 patients was 41.0% at 5 years; 36.0% for the LA group, 34.8% for the SVC group and 45.6% for the PA group. Pathological N status significantly influenced the overall 5-year survival rate; 61.5% for No, 51.1% for the N1 and 11.8% for the N2 groups （N2 group versus No group, P 〈0.0001, N2 versus N1 group, P〈0.0001）. Surgical resection also influenced survival; 49.4% for the complete resection group and 17.9% for the incomplete resection group （P 〈0.0001）. Cox regression analysis demonstrated that pathological N status was a significant independent predictor of prognosis. Conclusions Pathological N status is a significant independent predictor for survival of patients with IIIb-T4 lung cancer invading the left atrium and great vessels. The completeness of resection has a significant influence on the overall 5-year survival rate. Surgery for T4 lung cancer may be effective in patients without mediastinal lymph node involvement.
