支气管动脉和肺动脉多层螺旋CT血管造影对肺癌血供的研究

目的 用支气管动脉(BA)和肺动脉(PA)多层螺旋CT血管造影(BA—MSCTA和PA—MSCTA)的方法进一步研究肺癌血供。方法 对16例原发性肺癌患者分别行支气管动脉和肺动脉数字减影血管造影(BA—DSA和PA—DSA)后，留置导管行PA—MSCTA和BA—MSCTA，判定支气管动脉和肺动脉对肺癌的血供。结果 PA—MSCTA和PA-DSA上均未见明确的肺动脉供应肿瘤，也未见肿瘤内部和边缘有肿瘤血管和肿瘤染色。BA—DSA和BA—MSCTA上均可见肿瘤内部杂乱无章的肿瘤血管影，以及对比剂进入肿块内部。PA—MSCTA清晰显示肿块内部及其与肺动脉的关系。BA—MSCTA上5例可见肿瘤内血管和对比剂部分缺损，7例可见肺门和(或)纵隔淋巴结染色，其中BA-DSA上有肺门和(或)纵隔淋巴结染色的4例中，3例染色的淋巴结个数增多。结论 MSCTA是研究肺癌血供的较好方法，该研究再次证明肺动脉不参与原发性肺癌的血供，但应注意多支体循环供血的可能。

Bronchial arterial and pulmonary arterial multi-slice CT angiography: evaluation of blood supply of lung cancer

Objective To further evaluate the blood supply of lung cancer using bronchial arterial and pulmonary arterial multi-slice CT angiography (BA-MSCTA, PA-MSCTA). Methods PA-MSCTA and BA-MSCTA were performed on 16 patients with primary lung cancer after digital subtraction angiography of bronchial artery and pulmonary artery (BA-DSA, PA-DSA). Blood supply of the lung cancer from bronchial artery or pulmonary artery was assessed. Results No hypertrophic tumor vessel or tumor stain was observed within tumor on either PA-MSCTA or PA-DSA. While on both BA-DSA and BA-MSCTA, diffuse tumor vessels and tumor stains were observed in all the cases. PA-MSCTA clearly demonstrated the inside of the masses and their relationship with PA. On BA-MSCTA, partial defects of tumor vessel and tumor stain were observed in 5 cases, and hilar and(or) mediastinal lymph node enhancement was shown in 7 cases. In three of the four cases in which lymph nodes enhancement were seen on BA-DSA, more lymph nodes enhancement were seen on BA-MSCTA. Conclusion MSCTA is a better way for the evaluation of blood supply of lung cancer. By using MSCTA, it is further demonstrated that PA does not supply the primary lung cancer, but multiple systemic blood supply should be noticed.