摘要
目的 研究多排螺旋CT(MSCT)显示支气管与外周肺癌关系中的价值。方法 采用MSCT对 53例外周肺癌行层厚为 0 .5mm的容积靶扫描 ,通过多层面或曲面重建 (MPRorCMPR)以及表面遮盖显示 (SSD)的方法 ,显示支气管与外周肺癌的关系。将结果与手术标本、病理切片对照。结果 (1)全部第 3～ 7级支气管均全程清晰、完整的显示 ,肿瘤与支气管有关系者 :3 0例腺癌中 2 9例(9 6.7% ) ,17例鳞癌中 13例 (76.5% )。 (2 )肿瘤 支气管关系分为 4型 :Ⅰ型 :支气管被肿瘤截断 ;Ⅱ型 :支气管进入肿瘤锥状中断 ;Ⅲ型 :支气管在肿瘤内保持通畅 ;VI型 :支气管紧贴肿瘤边缘走行 ,形态正常或受压移位。 (3 )Ⅰ型发生率为 58.5% (3 1/ 53 ) ,其中鳞癌略多于腺癌 ;Ⅱ型和Ⅲ型均为15.1% (8/ 53 ) ,仅见于腺癌 ;Ⅳ型为 2 8.3 % (15/ 53 ) ,腺癌略多于鳞癌。 (4)与第 4级支气管相关的肿瘤 ,鳞癌多于腺癌 ;与第 6级支气管相关的肿瘤 ,腺癌多于鳞癌。结论 采用MSCT ,超薄层靶扫描后行MPR、CMPR和SSD重建能准确地显示肿瘤 支气管关系 。
Objective To investigate the value of multislice spiral computed tomograph y (MSCT) in demonstrating the relationship between bronchus and peripheral lung cancer. Methods We prospectively performed volumetric targeted scans of 0.5 mm co llimation with MSCT and reconstructed images of multiplanar reconstruction (MPR) ,curved multiplanar reformations (CMPR) and surface shaded display (SSD) in 53 peripheral lung cancers. The results were compared with macroscopic and microscopic specimens. Results (1) The third- to seventh-order branches of the bronchi were clearly shown in all pat ie nts by the designed protocol. CT demonstrated the tumor-bronchus relationship i n 29(96.7%) adenocarcinomas and 13(76.5%) squamous-cell carcinomas. Statistic an a lysis showed that there was no significant difference between the two groups ( χ 2=2.8, P >0.05 ). (2) The tumor-bronchus relationship was identif ied as four types with MSCT. Type Ⅰ: bronchus was obstructed abruptly by the tumor, ty pe Ⅱ: bronchus penetrated into the tumor with tapered narrowing and interruptio n, type Ⅲ : bronchus lumen shown within tumor was patent and intact, type Ⅳ: bronchus ran at the periphery of the tumor with intact or narrowed lumen. (3) Type Ⅰ was s hown in 31 of 53 (58.5%) tumors with squamous-cell carcinoma slightly more com m on than adenocarcinoma. Type Ⅱ and type Ⅲ were seen equally in 8 of 53 (15.1% ) tumors which occurred only in adenocarcinomas. Type Ⅳ was seen in 15 of 53 ( 28.3%) tumors with adenocarcinoma being slightly more frequent than squamous ce ll carcinoma. (4) The tumor at the fourth-order bronchus was more common in squ a mous cell carcinoma, whereas that at the fixth-order bronchus was more likely i n adenocarcinoma. Conclusion Volumetric targeted scan of ultra-thin section with MS CT and followed by MPR,CMPR and SSD reconstruction can greatly improve the mani festation of the bronchioles and accurately demonstrate the patterns of tumor-b ronchus relationship, thereby reflecting pathologic changes to some extent.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2004年第1期45-48,共4页
Chinese Journal of Oncology
