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目的 将螺旋CT血管成像 (SCTA)技术应用于肺动脉成像 ,探讨肺癌侵犯中央肺动脉 (CPA)的CTA影像特征。方法 收集具有中央肺动脉受侵征象 (CICPA)的中心型肺癌 3 0例进行螺旋CT肺血管成像(SCTPA) ,并以 3 0例正常SCTPA病例作对照。成像参数为 :扫描层厚 3mm ,螺距 1.5 ,重建间距 1.2mm ,造影剂注射速度 3～ 4ml/s。重点观察CPA行径、管径及强化程度的改变。结果 18例 ( 60 % )有CPA行径改变。CPA行径的改变取决于肿瘤的优势位置及侵犯途径。 2 6例 ( 86.7% )CPA管腔有不同程度的狭窄 ,表现为CPA管柱状偏心或向心性狭窄 ,管壁光滑僵硬。重度狭窄CPA的强化程度明显降低 (P <0 .0 5 ) ,而轻～中度狭窄CPA的强化程度改变不明显 (P >0 .0 5 )。结论 本研究显示肺癌CICPA的CTA直接征象包括CPA管腔狭窄、位移及强化程度的改变。SCTA在肺癌CICPA的诊断中有重要应用价值。
Objective To apply spiral CT angiography (SCTA) to pulmonary arteriography to investigate the features of CTA in lung cancer involving the central pulmonary artery (CPA). Methods Thirty patients with central lung cancer with central pulmonary artery involvement (CICPA) were enrolled in this study. Spiral CT pulmonary angiography (SCTPA) was performed in 30 patients with central lung cancer and 30 normal SCTPA cases were used as controls. The imaging parameters were: scan thickness 3mm, pitch 1.5, reconstruction distance 1.2mm, contrast agent injection speed 3 ~ 4ml / s. Focus on observation CPA path, diameter and degree of reinforcement changes. Results 18 cases (60%) had changes in CPA behavior. Changes in CPA behavior depends on the location of the tumor and violations. 26 cases (86.7%) of the CPA lumen have varying degrees of stenosis, manifested as CPA columnar eccentric or centripetal stricture, the smooth smooth wall. The degree of enhancement of severe stenosis CPA was significantly lower (P <0.05), while the degree of enhancement of mild to moderate stenosis CPA did not change significantly (P> 0.05). Conclusions This study shows that direct CTA imaging of CICPA in lung cancer includes changes in lumen stenosis, displacement, and enhancement of CPA. SCTA in the diagnosis of lung cancer CICPA has important application value.