增强CT扫描及多种后处理重建技术在评估中央型肺癌手术切除可能性中的应用

摘要

目的 探讨增强CT扫描及多种后处理重建技术在评估中央型肺癌手术切除可能性中的价值,以期提高中央型肺癌术前评估的准确性并指导临床治疗.方法 回顾性分析本院2015年1月至2016年6月行增强CT扫描且均经病理诊断证实为中央型肺癌的87例患者的临床资料,其中,51例经手术切除治疗,余36例经支气管镜或穿刺病理证实为肺癌,但未行手术治疗.分析87例患者治疗前的CT图像,采用多种后处理重建技术分析邻近结构肿瘤侵犯情况,判断肿瘤切除的可能性.采用统计学方法分析多种后处理重建技术联合应用的优势,总结不可切除肿瘤的CT征象.结果 多种后处理重建技术联合应用评估肿瘤侵犯支气管、肺动脉、上腔静脉及纵隔和肺门淋巴结的准确性均显著高于常规重建技术(P<0.05).可切除肿瘤和不可切除肿瘤的肿瘤长径、纵隔淋巴结肿大患者占比以及肿瘤侵犯肺动脉、上腔静脉、纵隔的患者占比比较均具有显著差异(P<0.05).结论 增强CT扫描及多种后处理重建技术的联合应用可明确显示中央型肺癌与周围血管及其他组织的关系,明确分期,有效指导手术治疗.%Objective To explore the value of enhanced CT scan with various of post-processing reconstruction techniques in evaluating the possibility of surgical resection of centtal lung cancer, so as to improve the accuracy of preoperative evaluation of central lung cancer and guide the clinical treatment. Method 87 cases proven central lung cancer were checked by contrast-enhanced CT in our hospital from January 2015 to June 2016. 51 cases were treated by surgical resection and another 36 cases without surgical resection proven by bronchoscopy or biopsy pathology. All images of 87 cases before treatment were retrospectively analyzed and reconstructed by various of post-processing reconstruction techniques to show the invasion of adjacent structures, and the resection possibility of tumors was evaluated. The advantage of combined application of various of post-processing reconstruction techniques was analyzed by statistics methods, and the CT finding features of unresectable central lung cancer were concluded. Result The accuracy of combination of various of post-processing reconstruction techniques in evaluating the invasion of bronchus, pulmonary artery, superior vena cava, mediastinum and hilar lymph node were significantly higher than that of conventional reconstruction techniques (P<0.05). There were significant differences in the length of tumor, mediastinal lymph node enlargement, and the number of tumor invading the pulmonary artery, superior vena cava and mediastinum in patients with resectable and non resectable tumors (P < 0.05). Conclusion Combined application of enhanced CT scan with various of post-processing reconstruction techniques can clearly show the relationship between central type lung cancer and peripheral vessels and other tissues, and can effectively guide the operation treatment.