中央型肺癌的胸片、螺旋CT及多平面、三维重建的应用

目的：讨论中央型肺癌的胸片、CT影像及探讨螺旋CT多平面、三维重建的临床运用价值。方法：回顾性分析30例经纤维支气管镜病理证实为中央型肺癌的胸片、CT影像，并对其中14例在螺旋CT扫描后进行多平面（MPR），三维重建（3D－SSD）。结果：胸片、CT影像为肺门肿块，支气管壁增厚、狭窄，阻塞性肺炎、肺不张，纵隔淋巴结肿大。螺旋CT后处理可明确显示中央型肺癌肿块及狭窄、阻塞的支气管形态。组织学分类为鳞癌、小细胞未分化癌、腺癌。结论：胸片、CT是诊断中央型肺癌基础方法，螺旋CT多平面、三维重建可以帮助提高中央型肺癌的诊断。

Diagnosis of central pulmonary carcinoma with chest radiography,spiral CT and application of multiple planar, 3-dimentional reconstruction

Objective To study the chest radiography and CT image of central pulmonary carcinoma and to evaluate the clinical application of spiral CT multiplanar reconstruction and 3-dimentional reconstruction.Methods The chest radiography and CT images were reviewed in 30 cases with central pulmonary carcinoma confirmed by fibro-bronchoscopy and pathological examinations.Multiplanar reconstruction(MPR)and 3-dimentional reconstruction(3D-SSD)were performed in 14 cases out of 30.Results Spiral CT and post-imaging processing definitely revealed the mass and the stenotic or obstructed bronchus.Tumors,obstructed or narrowed bronchus,thickened wall of the involved bronchus,obstructive pneumonia,atelectasic and mediastinal adenopathty were revealed in chest radiography and CT images.The tumors were squamous cell carcinoma and undifferentiated small cell carcinoma in histology.Conclusion The chest radiography and CT imaging are primary methods in diagnosing central pulmonary carcinoma.Spiral CT multiplanar reconstruction and 3-dimentional reconstruction could improves the diagnosis of central pulmonary carcinoma.