肺癌血供的动脉造影CT与DSA对照研究

目的 采用动脉造影CT(CTA)与DSA相结合的方法，进一步探讨支气管肺癌的血供来源，为肺癌的介入治疗提供理论依据。方法 20例支气管肺癌患，中央型14例，周围型6例。在介入治疗前分别行支气管动脉、肺动脉CTA和DSA检查。结果 20例肺癌的支气管动脉DSA均可见肿瘤血管显影及肿瘤染色，支气管动脉CTA（CTBA）则可见肿瘤明显强化，且强化血管位于肿瘤外带；肺动脉DSA与CTA（CTPA）均未见肺动脉分支向肿瘤供血。20例中，10例动脉DSA显示肿块所在区域肺动脉管径大小及肺血灌注正常，其CTPA则显示瘤肺交界区的肺动脉分支与肿块相贴或被肿块包埋，另10例DSA显示肺动脉管径变细、狭窄，甚至完全闭塞，而其对应的CTPA则未见肺动脉分支显影。结论 支气管动脉是肺癌的供血血管，肺动脉不参与肺癌供血。支气管肺癌的灌注化疗或栓塞治疗应经支气管动脉进行，而不必经肺动脉治疗。

Blood supply of bronchogenic carcinoma:comparative investigation based on CTA and DSA.

Purpose To further investigate the blood supply of bronchogenic carcinoma by the way of combining CTA with DSA,and therefore , to provide theoretical evidence for interventional theraphy of the disease. Methods The DSA and CTA of bronchial and pulmonary artery were performed simultaneously in 20 patients with bronchogenie carcinoma( 14 central tumors and 6 peripheral tumors). Results In 20 patients with lung cancer, both tumor vessesl apperance and tumor stain were observed from DSA of bronchial artery. Enhanced tumor and vessels which mainly distributed in the peripheral part of the tumor were observed from CTBA (CTA of bronchial artery)in the same patient.There was no evidence showed that lung cancer tissues were supplied by the pulmonary artery on DSA and CTPA(CTA of the pulmonary artery) .In 10 cases of 20 patients,the condition of pulmonary artery system and pulmonary blood perfusion were normal in the affceted area on DSA, While the branch of pulmonary artery were encased by tumor or attached to the tumor on CTPA. In other 10 cases, the branch of pulmonary arteries were thinned, narrowed or even obliterated on DSA and not able to be observed on CTPA. Conclusions The bronchial artery was the blood supply artery of lumg cancer. The pulmonary artery was the blood supply artery of lung cancer. The pulmonary artery didnt participate in the blood supply of cancer. Intra - arterial chemotherapy or emboliza-tion for lung cancer should be performed through the bronchial artery, While not via pulmonary artery.