目的:运用多层螺旋CT(MSCT)后处理技术显示周围性肺癌与支气管关系,分析其影像表现及诊断价值。方法:采用MSCT对77例周围性肺癌行层厚为0.5 mm的容积靶扫描,通过多平面或曲面重建(MPR或CMRP)以及表面遮盖(SSD)法显示支气管与周围肿块的关系,CT影像表现与手术、病理对照。结果:(1)全部3~7级支气管均全程、较完整显示。42例腺癌中与支气管有关系者为39例(92.9%),20例鳞癌中为15例(75.0%)。(2)肿瘤—支气管关系可分为4型:Ⅰ型,支气管被肿块截断;Ⅱ型,支气管进入肿块内后被截断;Ⅲ型,支气管在肿块内保持通畅;Ⅳ型,支气管紧贴肿块边缘走行,形态正常或受压移位。(3)发生率:Ⅰ型为48.1%(37/77),其中鳞癌略多于腺癌;Ⅱ型为13.0%(10/77),其中鳞癌略多于腺癌;Ⅲ型为16.9%(13/77),仅见腺癌;Ⅳ型为15.6%(12/77),腺癌略多于鳞癌。(4)与第四级支气管相关的肿块,鳞癌多于腺癌;与第六级支气管相关的肿块,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,能准确显示肿块与支气管关系,并反映一定的病理改变关系,对良恶性鉴别或长期预后等相关性研究有着重要意义。
Citation:
LI Liqun,HOU Junming,ZHAO Ke,et al.. Multislice CT Findings on the Association of Peripheral Lung Carcinoma with Bronchia. West China Medical Journal, 2009, 24(2): 397-400. doi:
Copy
1. |
Qiang JW,Zhou KR,Lu G,et al.The relationship between solitary pulmonary nodules and bronchi:multislice CTpathological correlation[J].Clin Radiol,2004,59:1121-1127..
|
2. |
蒋涛,石木兰,吕宁,等.孤立性肺结节的高分辨CT扫描(CT与病理对照)[J].中华肿瘤杂志,1998,20:216-217..
|
3. |
缪竞陶,朱培菊,张尚福,等.肺癌侵犯静脉干的CT、MRI表现及与病理的相关性研究[J].中华放射学杂志,1997,31:20-24..
|
4. |
Choi JA,Kim JH,Hong KT,et al.CT bronchus sign in malignant solitary pulmonary lesions:value in the prediction of cell type[J].Eur Radiol,2000,10:1304-1309..
|
5. |
黄佐良,何望春,周继华,等.血管集中征对周围性肺癌的诊断价值[J].中华放射学杂志,1999,33:48-50..
|
6. |
Gaeta M,Barone M,Russi EG,et al.Carcionomatous solitary pulmonary nodules:evluation of the tumorbronchi relationship with thin section CT[J].Radiology,1993,187:535,539.
|
- 1. Qiang JW,Zhou KR,Lu G,et al.The relationship between solitary pulmonary nodules and bronchi:multislice CTpathological correlation[J].Clin Radiol,2004,59:1121-1127..
- 2. 蒋涛,石木兰,吕宁,等.孤立性肺结节的高分辨CT扫描(CT与病理对照)[J].中华肿瘤杂志,1998,20:216-217..
- 3. 缪竞陶,朱培菊,张尚福,等.肺癌侵犯静脉干的CT、MRI表现及与病理的相关性研究[J].中华放射学杂志,1997,31:20-24..
- 4. Choi JA,Kim JH,Hong KT,et al.CT bronchus sign in malignant solitary pulmonary lesions:value in the prediction of cell type[J].Eur Radiol,2000,10:1304-1309..
- 5. 黄佐良,何望春,周继华,等.血管集中征对周围性肺癌的诊断价值[J].中华放射学杂志,1999,33:48-50..
- 6. Gaeta M,Barone M,Russi EG,et al.Carcionomatous solitary pulmonary nodules:evluation of the tumorbronchi relationship with thin section CT[J].Radiology,1993,187:535,539.