肺癌胸内淋巴结转移的CT与血管造影的对照研究

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目的:对照研究CT与支气管动脉造影对肺癌胸内淋巴节转移的显示率,及对支气管动脉灌注治疗的指导价值。对象及方法:选择有支气管动脉造影并且造影前两周内行CT检查,并由清理及临床、生化检查证实胸内淋巴结转移的患者23例,年龄41—77岁,平均62岁。男22例,女1例。CT显示中央型22例,周围型1例。对肺癌原发灶供血动脉行支气管动脉造影,并与相应CT的淋巴结显示情况进行对比。结果:①CT与支气管动脉造影共同确认的淋巴结30组,CT发现而支气管动脉造影未证实的13组,支气管动脉造影发现而CT未确认的7组淋巴结,均为肺不张的病例。②支气管动脉造影显示的淋巴结大小范围从1.0cm到2.5cm,平均1.68cm。CT显示的淋巴结大小范围从1.6cm到4.0cm,平均2.05cm。③淋巴结血供的支气管动脉造影表现:血管增粗迂曲,粗细不均匀,呈串珠状(19/37),也可呈网格状或弹簧状(7/37);淋巴结染色,表现为淋巴结染色,甚至呈“血管湖”状(7/37);血管呈弧形推压或包绕淋巴结,中心可为多血供或少血供(4/37)。结论:对大多数病例CT与支气管动脉造影对转移淋巴结的显示情况相当。当肺癌原发灶与淋巴结由不同动脉供血时,CT对于BAI治疗有指导意义。而当肺癌伴有肺不张时,支气管动脉造影诊断有很大帮助。综 OBJECTIVE: To study the display rate of intrathoracic lymph node metastasis of lung cancer by CT and bronchial arteriography, and the guiding value of bronchial arterial infusion therapy. Subjects and Methods: Twenty-three patients, aged 41-77 years old, with an average of 62 years of age who underwent CT scans with bronchial artery angiography and within two weeks before angiography and were confirmed by clinical cleanup and clinical and biochemical examinations for metastatic thoracic lymph nodes were selected. There were 22 males and 1 female. CT showed 22 cases of central type and 1 case of peripheral type. The bronchial arteriography was performed on the blood supply artery of primary lung cancer and compared with the corresponding lymph node display of CT. RESULTS: 1 There were 30 lymph node groups identified by CT and bronchial artery angiography, 13 cases that were found by CT and not confirmed by bronchial artery angiography, and 7 cases of lymph nodes discovered by bronchial arteriography but not confirmed by CT were all cases of atelectasis. 2 Bronchial arteriography showed lymph nodes ranging in size from 1.0 cm to 2.5 cm with an average of 1.68 cm. CT showed lymph node sizes ranging from 1.6cm to 4.0cm with an average of 2.05cm. Bronchial artery angiography of blood supply of lymph nodes: thickened blood vessels, uneven thickness, bead-like (19/37), grid-like or spring-like (7/37); lymph node staining, manifested as lymph node staining Even in the form of a “lake of blood vessels” (7/37); the blood vessels push or wrap around the lymph nodes, and the center can provide more blood or less blood (4/37). CONCLUSIONS: In most cases CT and bronchial arteriography are comparable to metastatic lymph nodes. When the primary lung cancer and lymph nodes are supplied by different arteries, CT has guiding significance for BAI treatment. When lung cancer is associated with atelectasis, the diagnosis of bronchial arteriography is of great help. Comprehensive
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