64排螺旋CT术前增强扫描在辅助诊断非小细胞肺癌淋巴结转移的应用价值分析
|
摘要
目的探讨64排螺旋CT术前增强扫描在辅助诊断非小细胞肺癌淋巴结转移的应用价值。方法选择2014年6月-2017年6月在我院及北京友谊医院进修期间诊断治疗的非小细胞肺癌患者120例为研究对象。所有患者采用Philips64排螺旋CT进行扫描,将术前增强CT影像学特点与术后淋巴结病理分期作对照分析。结果病理结果显示75例患者发生淋巴结转移,转移率62.5%,CT结果显示72例患者淋巴结肿大,占60.0%。CT检查淋巴结肿大结果:48例无淋巴结肿大,7例肺门淋巴结肿大,52例单纯纵隔淋巴结肿大,13例同时有肺门及纵隔淋巴结肿大。肿瘤直径>3cm,尤其是>7cm,淋巴结最小直径>1cm,纵隔淋巴结肿大以及肺门与纵隔淋巴结肿大患者淋巴结转移率高(P<0.05)。结论 CT通过诊断淋巴结大小判断是否有淋巴结转移存在一定的误差。肿瘤直径>3cm,尤其是>7cm,淋巴结最小直径>1cm,纵隔淋巴结肿大以及肺门及纵隔淋巴结肿大患者淋巴结转移率较高。
Objective To discuss the value of preoperative enhanced scan with 64 slice spiral CT in the diagnosis of lymph node metastasis in non-small cell lung cancer.Methods A total of 120 cases with non-small cell lung cancer from June 2014 to June 2017 were selected as subjects.All cases were scanned by Philips64 row spiral CT,and the preoperative enhanced CT imaging features were compared with the postoperative pathological staging of lymph nodes.ResultsPathological results showed that lymph node metastasis occurred in 75 patients,with a metastasis rate of 62.5%,and CT showed that lymph nodes were enlarged in 72 patients,accounting for 60%.CT examination results of lymph node enlargement showed:48 cases without lymph node enlargement,7 cases with hilar lymph nodes enlargement,52 cases with simple mediastinal lymph nodes enlargement,and 13 cases with hilar and mediastinal lymph node enlargement.The rate of lymph node metastasis in cases with the diameter of tumor was>3 cm,especially>7 cm,the smallest diameter of lymph node was>1 cm,mediastinal lymph node enlargement and hilar and lymph node enlargement was higher(P<0.05).Conclusion CT has certain errors in diagnosing lymph node metastasis by diagnosing the size of lymph nodes.Patients with the diameter of tumor was>3 cm,especially>7 cm,the smallest diameter of lymph node was>0.1 cm,mediastinal lymph node enlargement and hilar and lymph node enlargement are of higher lymph node metastasis rate.
Objective To discuss the value of preoperative enhanced scan with 64 slice spiral CT in the diagnosis of lymph node metastasis in non-small cell lung cancer.Methods A total of 120 cases with non-small cell lung cancer from June 2014 to June 2017 were selected as subjects.All cases were scanned by Philips64 row spiral CT,and the preoperative enhanced CT imaging features were compared with the postoperative pathological staging of lymph nodes.ResultsPathological results showed that lymph node metastasis occurred in 75 patients,with a metastasis rate of 62.5%,and CT showed that lymph nodes were enlarged in 72 patients,accounting for 60%.CT examination results of lymph node enlargement showed:48 cases without lymph node enlargement,7 cases with hilar lymph nodes enlargement,52 cases with simple mediastinal lymph nodes enlargement,and 13 cases with hilar and mediastinal lymph node enlargement.The rate of lymph node metastasis in cases with the diameter of tumor was>3 cm,especially>7 cm,the smallest diameter of lymph node was>1 cm,mediastinal lymph node enlargement and hilar and lymph node enlargement was higher(P<0.05).Conclusion CT has certain errors in diagnosing lymph node metastasis by diagnosing the size of lymph nodes.Patients with the diameter of tumor was>3 cm,especially>7 cm,the smallest diameter of lymph node was>0.1 cm,mediastinal lymph node enlargement and hilar and lymph node enlargement are of higher lymph node metastasis rate.
引文
[1]黄江华,雍大德,李传.低剂量螺旋CT扫描技术和高千伏胸部数字X线在肺癌筛选中的应用研究[J].广西医学,2015,37(12):1773.
[2]王建雄,吴彩玲,窦晓霞,等.分析胸部DR和低剂量螺旋CT扫描在82例肺癌筛选中的使用价值[J].影像技术,2015,27(3):34.
[3]成洪桥.胸部DR与低剂量螺旋CT扫描在肺癌筛选中的应用观察[J].中国卫生标准管理,2014,5(24):39.
[4]陈丽英.胸部数字化X线摄影与CT对早期周围型肺癌的诊断价值[J].当代医学,2012,18(24):156.
[5]王珂,吴红霞,罗民新,等.CT诊断中心型肺癌的准确性及MRI补充诊断的意义[J].中国CT和MRI杂志,2013,11(3):61.
[6]邢漠,王国庆,孙定涛,等.胸部CT扫描与X线平片对肺结核及肺癌空洞积液量的测量差异[J].中医临床研究,2015,7(33):134.
[7]于华龙,李绍科,李晓飞,等.正常纵膈淋巴结的解剖学观测及MSCT影像学研究[J].解剖与临床,2012,17(2):107.
[8]赵虹.CT对肺癌纵隔淋巴结转移的诊断价值[J].中国医学工程,2015,23(7):116.
[9]贺政,赵俊华,任慧雯,等.448例肺癌淋巴结转移规律分析及意义[J].山东医药,2011,51(26):72.
[10]韦文桦,何启辉,陈乾,等.64层螺旋CT对肺癌纵隔淋巴结转移的诊断价值[J].实用放射学杂志,2013,29(6):914.
[11]时贻林.高分辨率CT扫描对周围型肺癌的诊断分析[J].临床医药实践,2014,23(7):503.
[12]赵林,李会菊,李晓阳,等.术前增强CT检查与淋巴结转移相关性在非小细胞肺癌患者诊断中的研究[J].中国临床医生,2015,4:70.
[13]玄国庆,袁立华,亓子坤.周围型非小细胞肺癌纵隔淋巴结转移相关CT表现[J].临床肺科杂志,2015,20(4):639.
[14]吴仪仪,张建,左长京,等.PET/CT与增强CT对肺癌淋巴结诊断及分期的比较[J].临床肺科杂志,2014,19(10):1846.
[15]沈静娴,谢传淼,习勉,等.能谱CT定量指标在鉴别诊断非小细胞肺癌转移淋巴结与非转移淋巴结中的价值[J].中山大学学报:医学科学版,2014,35(5):738.
[2]王建雄,吴彩玲,窦晓霞,等.分析胸部DR和低剂量螺旋CT扫描在82例肺癌筛选中的使用价值[J].影像技术,2015,27(3):34.
[3]成洪桥.胸部DR与低剂量螺旋CT扫描在肺癌筛选中的应用观察[J].中国卫生标准管理,2014,5(24):39.
[4]陈丽英.胸部数字化X线摄影与CT对早期周围型肺癌的诊断价值[J].当代医学,2012,18(24):156.
[5]王珂,吴红霞,罗民新,等.CT诊断中心型肺癌的准确性及MRI补充诊断的意义[J].中国CT和MRI杂志,2013,11(3):61.
[6]邢漠,王国庆,孙定涛,等.胸部CT扫描与X线平片对肺结核及肺癌空洞积液量的测量差异[J].中医临床研究,2015,7(33):134.
[7]于华龙,李绍科,李晓飞,等.正常纵膈淋巴结的解剖学观测及MSCT影像学研究[J].解剖与临床,2012,17(2):107.
[8]赵虹.CT对肺癌纵隔淋巴结转移的诊断价值[J].中国医学工程,2015,23(7):116.
[9]贺政,赵俊华,任慧雯,等.448例肺癌淋巴结转移规律分析及意义[J].山东医药,2011,51(26):72.
[10]韦文桦,何启辉,陈乾,等.64层螺旋CT对肺癌纵隔淋巴结转移的诊断价值[J].实用放射学杂志,2013,29(6):914.
[11]时贻林.高分辨率CT扫描对周围型肺癌的诊断分析[J].临床医药实践,2014,23(7):503.
[12]赵林,李会菊,李晓阳,等.术前增强CT检查与淋巴结转移相关性在非小细胞肺癌患者诊断中的研究[J].中国临床医生,2015,4:70.
[13]玄国庆,袁立华,亓子坤.周围型非小细胞肺癌纵隔淋巴结转移相关CT表现[J].临床肺科杂志,2015,20(4):639.
[14]吴仪仪,张建,左长京,等.PET/CT与增强CT对肺癌淋巴结诊断及分期的比较[J].临床肺科杂志,2014,19(10):1846.
[15]沈静娴,谢传淼,习勉,等.能谱CT定量指标在鉴别诊断非小细胞肺癌转移淋巴结与非转移淋巴结中的价值[J].中山大学学报:医学科学版,2014,35(5):738.