探讨周围型非小细胞肺癌纵隔淋巴结转移相关CT表现

目的 分析周围型非小细胞肺癌(NSCLC)纵隔淋巴结转移的相关CT影像学因素.方法 回顾性分析术前接受胸部增强CT检查的101例周围型NSCLC患者.对所有患者均行纵隔淋巴结清扫术.由2名医师盲法阅读术前CT资料,记录肿瘤的位置、大小、密度、增强CT值、分叶、毛刺及胸膜凹陷情况,纵隔淋巴结是否显示及显示淋巴结的大小、数目及边界情况,采用单因素及多因素分析进行筛选.结果 纵隔淋巴结大小、边界、肿瘤大小、位置、密度、胸膜凹陷及肿瘤病理类型是纵隔淋巴结转移的独立影响因素.结论 周围型NSCLC纵隔淋巴结转移不仅与淋巴结大小相关,还与淋巴结边界、肺癌的大小、密度、位置及胸膜凹陷等多种CT表现相关,综合分析多种因素有助于提高CT诊断周围型NSCLC纵隔淋巴结转移的水平.

CT evaluation on mediastinal lymph nodes in patients with peripheral non-small cell lung cancer

Objective To investigate the relevant CT findings of mediastinal lymph node metastasis in patients with non-small cell lung cancer (NSCLC). Methods Totally 101 patients with NSCLC who underwent CT scan preoperatively were retrospectively investigated. All these patients received mediastinal lymph node dissection. CT images were reviewed by 2 radiologists blindly, and tumor location, size, attenuation, contrast CT values, lobulation, spiculation, pleural indentation, the exist, the size and number of mediastinal lymph nodes and border were recorded. The relative factors of metastasis were selected with oneway and multiple factors analysis. Results The independent factors of metastasis included diameter and border of lymph node, tumor size, location, attenuation, pleural indentation and histological type. Conclusion Besides the size of mediatstinal lymph nodes, there are several factors relative to metastasis of mediastinal lymph node, including node border, tumor size, attenuation, location and pleural indentation. The criteria combining these parameters are helpful to increase CT validity in diagnosis of mediastinal lymph nodes metastasis in patients with peripheral NSCLC.