摘要
目的:探讨64层CT对原发性肺癌供血动脉的显示能力。方法:对经病理证实的原发性肺癌62例及正常对照30例进行回顾性分析。增强CT扫描时间为注药后28～30s,后处理进行VR、MIP及MPR重建。结果:肺癌组62例中61例VR可以重建出支气管动脉(BA),正常对照组30例中26例可以重建出BA。肺癌组共重建出161支BA,平均2.6支/人;正常对照组共重建出45支BA,平均1.5支/人,肺癌组VR重建BA数明显多于正常对照组。肺癌组右侧显示1支BA的占69.3%,左侧显示2支以上BA的占50%,R1L2型占肺癌组总数的35.5%。共发现7支变异的BA,均从锁骨下动脉及分支发出。共发现6例异常体动脉供血,分别为肋间后动脉、内乳动脉和锁骨下动脉。肺癌组肺癌同侧BA行程明显较正常对照组及肺癌对侧长。肺癌组34例可显示肿瘤血管形成。肺癌组肺癌同侧BA直径及截面积较正常对照组增加,肺癌对侧直径及截面积较正常对照组增加(P<0.05);肺癌同侧较肺癌对侧BA直径增粗、截面积明显增加(P<0.05)。肺癌癌肿越大,引起的BA血流量增加越明显。结论:64排CT能定量分析原发性肺癌BA扩张和总供血量增加等病理生理特征,并可显示异常BA的起源及异常体动脉的供血,CTA可以显示肿瘤血管形成,对原发性肺癌血供研究及指导肺癌介入途径的选择具有重要价值。
Objective： To investigate the ability of 64-row CT in demonstrating blood supply of primary lung cancer. Materials and Methods： 64-row CT scans were performed in 62 primary lung cancer cases and 30 normal control cases. The contrast-enhanced CT was performed 28-30s after injecting contrast medium. The images reconstructions of VR, MIP and MPR were performed at AW 4.2 workstation. Results： The mean number of bronchial arteries （BA） reconstructed on cancer group was more than that in the control group, 2.6 vs 1.5 per case respectively. 69.3% cases in cancer group displayed only one BA in the right lung and 50% showed more than two BA in the left lung. The BA of R1L2 accounted for 35.5% of lung cancer cases. Seven aberrant BA were detected, which were originated from subclavian arteries and its branches. In 6 cases systemic arteries supplied lung cancers, including 3 cases of intercostal arteries, 2 cases of internal mammary arteries and 1 case of subclavian artery. In lung cancer group, 34 cases could demonstrate tumor vasiformation on MIP reconstruction. The caliber of BA and the total axial areas on the side of the lung cancer were larger than those of the opposite side and of the control group （P〈0.05）. BA axial area was correlated with tumor size but not with location. Conclusion： 64-row CT can pro- vide information about anatomy and morphology of BA, aberrant BA origin and abnormal systemic artery blood supply of tumors. Tumor vasiformation can be detected with MIP reconstruction. These are helpful for study of blood supply of tumor and transcatheter bronchial arterial chemoembolization of primary lung cancer.
出处
《中国临床医学影像杂志》
CAS
北大核心
2008年第9期627-630,645,共5页
Journal of China Clinic Medical Imaging
