乳腺癌术后胸部转移的螺旋CT表现特征

目的:探讨乳腺癌术后胸部转移的螺旋CT表现特点及其优势解剖分布。方法:回顾性分析40例乳腺癌术后的螺旋CT资料,总结肿瘤转移的类型、解剖部位及其转移时间的分布特点,并进行统计分析。结果:40例乳腺癌术后患者中,双肺转移23例(23/40,57·5%);淋巴结转移12例(12/40,30%),主要位于气管前间隙(9/12,75%)、主肺动脉窗(5/12,41·6%)和气管隆突下间隙(4/12,33·3%);胸腔积液17例(42·5%),胸膜增厚10例,心包积液8例(20%)。胸壁肿块形成5例(12·5%)。肺转移明显高于纵隔淋巴结转移和其他转移类型。肺转移的发生率在术后5年明显高于术后1年,其他阶段无明显差异。结论:乳腺癌术后的胸部转移以血行转移为主要途径。转移类型与发生时间无明显关系。螺旋CT对乳腺癌术后胸部转移的诊断具有较高的应用价值。

Thoracic Metastasis of Postoperative Breast Cancer:Evaluation with Helical CT

Objective:To determine the helical CT features of thoracic metastasis in patients with breast cancer postoperatively.Methods:We examined the helical CT information in 40 postoperative patients with breast cancer clarified by surgery and pathology.On the basis of axial CT imaging,CT features were evaluated,including metastatic types,anatomic distribution of lesions and time of metastasis in patients with breast cancer.Results:Of 40 patients,there are metastasis of both of lung in 23 (57.5%),lymph node enlargement in 12 (30%) which located predominantly in anterior space of trachea (9/12,75%),aortic-pulmonary window (5/12,41.6%) and sub carina (4/12,33.3%).There were 17 cases(42.5%) with pleural effusion and 10 with pleural thickening,as well as 8 with cardiac effusion(20%).The rate of lung metastasis is higher than that of other types (P<0.05).The metastatic rate of all types have no correlation with the time of the post-operation (P>0.05).Conclusions:Hematogeneous spread is the main pathway of metastasis predominantly after mastectomy with breast cancer.Helical CT is efficient and reliable as a following-up screening.