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目的 分析肺癌侵犯中央肺动脉后致肺低灌注的数字减影血管造影 (DSA)影像特征 ,探讨肺动脉受累程度与肺低灌注间的关系 ,为临床制定治疗方案提供更多的信息。方法 收集CT显示侵犯肺动脉的中央型肺癌患者 2 6例 ,行肺血管DSA检查。观察肺低灌注的DSA影像特征 ,描绘受累肺叶及健侧对应区域肺实质时间 -密度曲线 (TDC)。结果 2 6例中 38支叶肺动脉受侵 ,34个肺叶 ( 89.5 % )出现肺低灌注。肺低灌注与肺动脉受累后狭窄程度密切相关 (P <0 .0 5 )。DSA像上肺血管征表现为肺动脉中断 ( 11.8% ,4/34 )或分支数量减少 ( 88.2 % ,30 /34 ) ,末梢肺动脉消失 ( 41.2 % ,14 /34 )或减少 ( 5 8.8% ,2 0 /34 ) ;肺实质征表现为肺组织毛细血管充盈消失 ( 14 .7% ,5 /34 )或减弱 ( 85 .3% ,2 9/34 )。结论 肺癌侵犯中央肺动脉后致该动脉供血区域出现肺低灌注 ,肺低灌注与肺动脉狭窄程度密切相关。肺实质征及肺血管征是肺低灌注的重要征象。
Objective To analyze the features of digital subtraction angiography (DSA) imaging of pulmonary hypoperfusion after lung cancer invading the central pulmonary artery, and to investigate the relationship between pulmonary artery involvement and hypoperfusion, and provide more information for clinical treatment planning. Methods Twenty-six patients with central lung cancer who had invaded the pulmonary arteries on CT scans were recruited for DSA. Observe the features of DSA images of hypoperfusion of the lungs, and plot the time-density curve (TDC) of the lung parenchyma in the affected lobe and the corresponding region on the contralateral side. Results Of the 26 patients with 38 pulmonary lobes, 38 patients suffered pulmonary hypoperfusion in 34 (89.5 %) lobes. Pulmonary hypoperfusion was closely related to the extent of pulmonary stenosis (P < 0.05). Pulmonary vascular signs on the DSA showed pulmonary artery interruption (11.8%, 4/34) or decreased number of branches (88.2%, 30/34), disappearance of peripheral pulmonary artery (41.2%, 14/34), or decrease (5.8%, 2%). 0 / 34 ) ; Pulmonary parenchymal manifestations were disappearance of pulmonary capillary filling (14.7%, 5/34) or weakened (85.3%, 29/34). Conclusion Lung hypoperfusion appears in the blood supply area of the artery after lung cancer invades the central pulmonary artery, and hypoperfusion is closely related to the degree of pulmonary artery stenosis. Lung parenchymal signs and pulmonary vascular signs are important signs of hypoperfusion.