术中超声检查在判断肺癌可切除性方面的研究

目的 :评估术中超声判断肺癌与肺血管关系的准确性 ,预测肺癌可切除性及术式的准确性。材料和方法 :用CT作对照 ,以手术病理结果为标准 ,采用评分的方法 ,定量描述术中超声判断肿瘤与肺血管关系的准确性 ,及其预测肺癌的可切除性和术式的准确性。结果 :术中超声判断肿瘤与肺血管关系的准确率 ( 81.0 % )要高于CT( 72 .3 % ) ,肿瘤的部位和大小对于判断的准确率有影响 ,右侧肺癌的判断准确率高于左侧 ;平均直径 3～ 5cm肺癌的准确率最高。术中超声判断中心型肺癌可切除的准确率较高 ( 86.7% ) ,预测术式的准确率仅有 63 .3 %。结论 :术中超声有助于判断中心型肺癌与肺血管的关系并预测其可切除性 ,有助于选择正确的术式 ,减少术中意外损伤。

Clinical Study of Intraoperative Ultrasonography in Judging the Resectability of Lung Cancer

Purpose: To evaluate the accuracy of intraoperative ultrasonography (IOUS) in predicting the resectability of lung tumor. Meterials and Methods: In light of the actual findings in operation, the accuracy of IOUS in revealing the relationship of tumor and pulmonary vessel was quantitatively compared with that of CT. The capability of IOUS in predicting the resectability of tumor and in judging the surgical mode was also evaluated. Results: The accuracy of IOUS and CT in depicting the relationship of tumor and pulmonary vessel were 81.0% and 72.3% respectively. The result was affected by the location and size of the tumor, as the accuracy was higher in right lung than in left, and the best result was obtained in tumors ranging 3 5cm in diameter. The accuracy of IOUS was high in predicting the resectability of tumor(86.7%),but low in predicting the outcome of surgical method (63.3%). Conclusion: IOUS is of value in lung cancer surgery, particularly in judging the relationship between central type tumor and pulmonary vessels, predicting the resectability of tumor, and preventing accidental injury during operation.