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目的探讨肺癌致上腔静脉综合征CT表现类型及相应病理学基础。方法本组肺癌致上腔静脉综合征51例均经病理学确诊。回顾性分析其梗阻部位、梗阻程度、梗阻段周围病变CT表现及其病理性质,并作统计分析。结果上腔静脉梗阻段周围病变CT表现:环状包埋11例、半环状包埋5例、夹心状包埋5例、推移10例、向左推压15例、完全闭塞5例。梗阻程度不同,前五者发生率差异有统计学意义(P<0.05)。梗阻段周围病变为单纯肺内肿块直接蔓延7例,单纯上腔静脉周围转移淋巴结肿大融合17例,二者并存27例。梗阻CT表现类型、梗阻部位不同,其病理来源均有差异。结论肺癌致上腔静脉梗阻CT表现类型与梗阻程度有关。梗阻的病理性质与梗阻部位、梗阻CT表现类型有关。
Objective To investigate the CT manifestations and pathological basis of pulmonary vena cava caused by superior vena cava syndrome. Methods The group of 51 cases of lung cancer caused by superior vena cava syndrome were confirmed by pathology. Retrospective analysis of the obstruction site, degree of obstruction, CT findings of the lesions around the obstruction and pathological properties, and for statistical analysis. Results The CT findings of the lesions around the superior vena cava obstruction included 11 cases of annular embolization, 5 cases of semi-annular embedding, 5 cases of sandwich embedding, 10 cases of progressive laryngoplasty, 15 cases of left-sided obstruction and 5 cases of complete occlusion. The degree of obstruction was different, the first five were significantly different (P <0.05). The lesions around the obstruction segment were directly spread in 7 cases with simple intrapulmonary masses, and only 17 cases were swollen and lymphatic metastasis around the superior superior vena cava in 27 cases. Obstructive CT manifestations, obstruction of different parts of the pathological sources are different. Conclusions CT findings of superior vena cava obstruction in lung cancer are related to the degree of obstruction. The pathological nature of obstruction and obstruction site, obstructive CT manifestations related.