支气管动脉CTA检查在中央型肺癌患者介入术前的指导价值

doi:10.7517/issn.1674-0475.190924

摘要/Abstract

摘要： 为探讨支气管动脉CT血管造影（CTA）检查在中央性肺癌患者介入术前的指导价值，本研究选取因反复肺癌咯血于我院行支气管动脉CTA检查的中央性肺癌患者56例，另选取同期正常对照组15例。所有患者均进行支气管动脉栓塞术，比较CTA影像学检查结果。结果显示，左肺癌患者的L支气管动脉显影率、右肺癌患者的R支气管动脉显影率均显著高于对照组，差异均具有统计学意义（P<0.05）；左、右肺癌患者的L、R支气管动脉内径均显著高于对照组，差异均具有统计学意义（P<0.05）；左肺癌患者的支气管动脉解剖分型以Grade 4型为主，占72.2%；右肺癌患者的支气管动脉解剖分型以Grade 1型为主，占47.4%。共检出咯血动脉76支，其中支气管动脉58支、肺循环动脉10支、多种动脉交通吻合型6支、肋间动脉2支。28例肺癌患者的供血支气管动脉至少有1个弯角≤ 90°，走行迂曲，CTA可见点或网状肿瘤血管，内肺动脉被包绕，狭窄；部分肺外体循环参与供血的患者，其病灶邻近的胸膜增厚。研究结果显示，支气管动脉CTA检查可有效提供支气管动脉的分支类型、解剖分型及开口部位，能较好地观察肺内疾病的血供来源，为患者介入治疗提供参考。

关键词: 中央性肺癌, 支气管动脉, CT血管造影, 介入术

Abstract: To investigate the guiding value of bronchial artery CT angiography (CTA) in patients with central lung cancer before interventional therapy, 56 patients with central lung cancer who underwent bronchial artery CTA examination in our hospital due to recurrent hemoptysis of lung cancer were selected as the research object, and another 15 cases of normal control group in the same period were selected, in this study. All patients underwent bronchial artery embolization, and the results of CTA imaging were compared. The results showed that, the development rate of L bronchial artery in patients with left lung cancer and R bronchial artery in patients with right lung cancer were significantly higher than those in control group (P<0.05). The diameter of L and R bronchial artery in left and right lung cancer patients was significantly higher than that in control group (P<0.05). Grade 4 was the main type of bronchial artery anatomy in patients with left lung cancer, accounting for 72.2%. Grade 1 was the main type of bronchial artery anatomy in right lung cancer patients, accounting for 47.4%. A total of 76 hemoptysis arteries were detected, including 58 bronchial arteries, 10 pulmonary circulation arteries, 6 anastomotic arteries and 2 intercostal arteries. In 28 patients with lung cancer, the blood supply bronchial artery of patients had at least one bend angle less than 90°, which was circuitous. CTA showed dotted or reticular neoplasm vessels with narrow inner pulmonary artery, and pleural thickening adjacent to the lesion in some patients with extrapulmonary circulation participating in blood supply. This study shows that, CTA examination can effectively provide the branch type, anatomical classification and opening position of tracheal artery, better observe the source of blood supply of pulmonary diseases, and provide reference for interventional treatment of patients.

Key words: central lung cancer, bronchial artery, CT angiography, interventional procedures

中图分类号:

王晓燕, 肖继伟. 支气管动脉CTA检查在中央型肺癌患者介入术前的指导价值[J]. 影像科学与光化学, 2020, 38(2): 318-322.

WANG Xiaoyan, XIAO Jiwei. Guiding Value of Bronchial Artery CTA Examination before Interventional Therapy in Patients with Central Lung Cancer[J]. Imaging Science and Photochemistry, 2020, 38(2): 318-322.

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