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目的:探讨多层螺旋CT检查,肺癌肺切除术后肺动脉残端充盈缺损的发生率及其CT表现。方法:回顾性分析1999年~2003年间132例患者的胸部平扫和增强CT图像,男85例,女47例,平均年龄62.3岁(25岁~80岁)。56例行右肺切除手术,76例左肺切除手术。观察增强CT是否出现肺动脉残端充盈缺损、大小、形态和随访CT上的变化。测量平扫和增强CT的CT值。测量肺动脉残端的长度,观察远离肺动脉残端的其他肺动脉内是否出现血栓。结果:肺动脉残端的充盈缺损见于17例肺癌肺切除患者(12.9%),充盈缺损局限于血管腔内,右侧肺动脉残端充盈缺损发生率为26.8%,左侧发生率为2.6%(P<0.001)。右肺动脉残端的平均长度长于左侧(P<0.001)。平扫和增强CT的CT值无明显变化。随访CT,大部分病灶无变化或缩小。结论:肺癌肺切除术后在CT上出现肺动脉残端充盈缺损并不罕见,原位血栓形成应与肿瘤复发、肺血栓栓塞相鉴别。
Objective: To investigate the incidence and CT appearance of pulmonary artery stump filling defect after multi-slice spiral CT in lung cancer patients. Methods: Thoracic and CT images of 132 patients from 1999 to 2003 were retrospectively analyzed. There were 85 males and 47 females with a mean age of 62.3 years (ranging from 25 to 80 years). 56 cases of right lung resection and 76 cases of left lung resection. To observe the enhanced CT whether the pulmonary artery stump filling defects, size, shape and follow-up CT changes. Measure the CT value of plain scan and enhanced CT. Measure the length of the stump of the pulmonary artery to see if thrombi appear in other pulmonary arteries away from the stump of the pulmonary artery. Results: Filling defect of pulmonary artery stump was found in 17 cases of lung cancer patients (12.9%). The filling defect was confined to the vessel cavity. The incidence of filling defects in the right pulmonary artery stump was 26.8% and the incidence of left side was 2.6% (P < 0.001). The average length of the right pulmonary artery stump was longer than the left (P <0.001). CT value of CT and CT did not change significantly. Follow-up CT, most lesions no change or shrink. CONCLUSION: It is not uncommon to find the filling defect of pulmonary artery in CT after lung cancer resection of lung cancer. In situ thrombosis should be differentiated from tumor recurrence and pulmonary thromboembolism.