肺癌解剖位置与支气管动脉改变的相关性分析

目的：利用螺旋CT血管成像（CTA）分析中央型与周围型肺癌支气管动脉（BA）改变特点,区别肺癌BA改变与肿瘤大小及解剖位置的相关性.资料与方法：收集原发性肺癌50例（中央型及周围型肺癌各25例）,分为结节组（肿瘤直径≤30mm）和肿块组（肿瘤直径＞30 mm）;正常对照30例.采用64层螺旋CT胸部增强扫描,用最大密度投影（MIP）及容积再现（VRT）等方法进行观察,分析BA起源、形态学特征及其与肺癌的解剖学关系.结果：正常对照组30例均可显示BA,其中右侧共显示50支（平均1.7支/例）,左侧53支（平均1.8支/例）.肺癌组50个癌灶供血BA均能清晰显示,共90支（平均1.8支/例）.正常对照组BA平均管径1.4 mm.中央型肺癌结节组12例平均管径1.8 mm,肿块组13例平均管径约2.9 mm,合计平均管径2.6 mm.周围型肺癌结节组9例平均管径1.5 mm,肿块组16例平均管径2.0 mm,合计BA平均管径1.8 mm,周围型肺癌结节组BA与正常对照组比较无统计学意义（P＞0.05）,中央型和周围型肺癌肿块组及中央型肺癌结节组BA较正常对照组BA增粗,有统计学意义（P＜0.001）,中央型肺癌BA较周围型肺癌BA明显增粗,有统计学意义（P＜0.01）.结论：螺旋CT能够有效地显示BA,肺癌BA的改变与肿瘤的大小及位置均存在一定的相关性.

Correlation between the anatomical location of lung cancer and changes of the bronchial artery

Objective：Using spiral CT angiography（CTA） for assessing the changes of bronchial artery（BA） in central and peripheral lung cancer,the difference in BA changes with tumor size and location.Methods：The study was approved by the institutional research board.Fifty patients with pathologically confirmed lung cancer （25 cases in each of the central and peripheral lung cancer）,were divided into nodular group（tumor diameter ≤30 mm） and mass group（tumor diameter 〉30 rmm）; 30 normal individuals were included.Pre-and post-enhanced chest CT scan were performed in all of the cases.CTA was processed from the data of arterial phase CT scan after contrast material was injected.Post-processing included multiple plane reconstruction（MPR）,maximum intensity projection（MIP）,and volume rendering technique（VRT）.The origins,morphological features of the BA and its relationship with the tumor were carefully observed.Results：All of the 30 cases of normal control group showed BA,50 arteries on the right side（average 1.7/case）,53 arteries on the left side（average 1.8/case）.In 50 cases of lung cancer,90 arteries were showed （an average of 1.8/case）.The average diameter of BA was 1.4 mm in the control group.The average diameter of BA was 1.8 mm in the 12 central lung cancer （nodule group）,13 cases the average diameter was 2.9 mm in the mass group,total average diameter was 2.6 mm.The average diameter of BA was 1.5 mm in the 9 peripheral lung cancer nodule group.The average diameter was 2.0 mm in the 16 cases of the mass group,total average diameter was 1.8 mm.BA of peripheral lung nodule group compared with normal control group,there was no significant difference （P〉0.05）.There was significant difference in internal diameter of BA in mass group of peripheral lung cancer and central of the nodule group when compared with normal control group （P〈0.001）.The diameter of BA was significantly increased in the central lung cancer than that in the peripheral lung cancer （P〈0.01）.Conclusions：Spiral CT can effectively show the BA,BA changes have certain relevance with the tumor size and location.