Objective: To investigate the value of 64 row spiral computed tomography (MSCT) in the diagnosis of tra chea,bronchi and hilar vascular invasion by central type of lung cancer (CLC). Methods:Seventy five cases of CLC under went MSCT examination with post processing techniques including multiplanar reformation (MPR) ,curved planar reforma tion (CPR) ,volume rendering (VR) ,minimum intensity projection (MinIP) ,maximum intensity projection (MIP) and CT virtual endoscopy (CTVE). The relationship of trachea,bronchi,pulmonary hilar vessels with the neoplasm was studied. Results :Invasion of trachea and bronchi by CLC included extraluminal compression type (38 cases,50. 7%) ,which was showed on CT as compression and/or invasion of bronchi led to uneven stenosis;infiltration of bronchial wall(28 cases,37.3%)12. 0%) showed as protruding of neoplasm into the lumen which led to eccentric stenosis of trachea/bronchi. Altogether 117 hilar vessels were invaded by CLC,of which,95 (81. 2%) could be assessed on CT,showing obvious narrowing or oblitera tion; blood vessels encircled by tumor (n = 12,10. 3%) , and tumor thrombosis (n=10,8. 5%). Conclusion: The anatomic features of trachea,bronchi,and hilar vessels and their spacial relationship with CLC could be accurately assessed on 64 row spiral CT with post processing techniques, which provides significant information in judging whether there are trachea, bronchi, and hilar vessel invasion by CLC.%目的:探讨64排螺旋CT及后处理技术在判断中央型肺癌(CLC)对气管、支气管及肺门血管侵犯中的价值.方法:75例经纤支镜或病理确诊的CLC患者行64排螺旋CT扫描,运用多平面重组、曲面重组、容积再现、最大密度投影、CT仿真内窥镜等后处理技术观察肿瘤与气管、支气管及肺门血管的关系.结果:肿瘤对气管、支气管的侵犯表现为管外压迫型38例(50.7%),CT表现为肿瘤压迫并侵犯支气管,管腔内呈不均匀狭窄;管壁浸润型(28例,37.3%)CT表现为管壁不规则增厚,呈向心性狭窄;管内增生型(9例,12.0%)CT表现为肿块突入管腔,支气管管腔呈偏心性狭窄.肿瘤共侵犯117支肺门血管,其中95支(81.2%)CT可见血管明显狭窄或闭塞;12支(10.3%)CT可见肿瘤环绕血管生长;10支(8.5%)CT可见瘤栓形成.结论:64排螺旋CT及后处理技术能准确显示气管、支气管、肺门血管的解剖结构及其与中央型肺癌肿块的空间关系,对判断中央型肺癌侵犯气管、支气管、肺门血管有重要价值.
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