肺癌影像学与切除率的关系研究

 目的　探讨肺癌病人开胸探查的指征。方法　将术中所见与影像学进行比较分析。结果　CT片上肿瘤与纵隔的接触直径大于 3cm的 2 1例患者中 ,术中有 19例肺门呈冰冻状 ;2 4例纵隔脂肪垫消失的患者中 ,有 2 3例无法解剖肺门的血管及支气管 ;MRI报告病变与大血管之间脂肪层中断 ,病变包围大血管周径大于 1/ 2的 2 1例患者中 ,术中见肿瘤包绕肺动脉 11例、肺静脉 7例、胸主动脉 1例、上腔静脉 2例。结论　当CT报告肿瘤与纵隔的接触直径大于 3cm ,或纵隔脂肪垫消失 ,或MRI报告病变与大血管之间脂肪层中断 ,病变包绕大血管的周径大于 1/ 2时应慎行开胸探查术。

The relationship between image of lung cancer and resection rate

Objective Discuss the indication of the exploratory thoracotomy for cancer patients.Methods Compare and analyze the conditions observed in operations with iconography.Results Among the 21 patients of whom the contact diameter between the tumor and mediastinum on the CT photograph is larger than 3 centimeters, there are 19 of them whose hilums display frozen state in operations; 23 out of the 24 patients with disappeared mediastinal fat pad are unable to be executed dissection of hilum vessel and bronchus. It is reported in MRI that the fat layer discontinues between the pathology and great vessels, and among the 21 patients with the peripheral diameter of pathology surrounding great vessels larger than 1/2, there are in operations 11 cases of tumor encysting pulmonary arteries discovered, 7 cases of tumor encysting pulmonary veins, 1 case of tumor encysting thoracic aorta and 2 cases of tumor encysting superior vena cava.Conclusion When it is shown in CT that the contact diameter between tumor and mediastinum is larger than 3 centimeters or that the mediastinum fat pad disappears, or it is shown in MRI that the fat layer between the pathology and great vessel discontinues with the peripheral diameter of pathology encysting great vessel larger than 1/2, cautions must be used to undertake exploratory thoracotomy.