Fasse A, Kauczor H U, Mayer E, Kreitner K F, Heussel C P, Thelen M
Klinik und Poliklinik für Radiologie, Universität Mainz.
Rofo. 1999 Jan;170(1):112-8. doi: 10.1055/s-2007-1011018.
Primary pulmonary artery sarcomas are very rare tumors. Their diagnosis is difficult due to their unspecific symptoms. Still, an early preoperative diagnosis is the only possibility for a potential therapy.
4 pre- and 5 postoperative CT- and three pre- and one postoperative MRT-examination(s) have been evaluated with respect to surgical and histological findings.
The presence of a convex intraluminal bulging mass spreading mostly from the pulmonary trunc continuously into the peripheral pulmonary artery branches the filling and dilatation of the vessels, the tumor's inhomogeneity indicating hemorrhages and necrosis and the appearance of intrapulmonary nodules are found in both CT and MRI. Recurrent pulmonary artery sarcoma features an extravascular growth and is similar to lung cancer affecting the vessels. It shows contrast enhancement both in CT and MRI while the primary tumor shows a distinct contrast enhancement only of Gadopentetate dimeglumine but none or little enhancement in CT.
The criteria presented in knowledge of CT and MRI serve to increase the probability for a correct preoperative diagnosis and thus allow adequate surgical planning.
原发性肺动脉肉瘤是非常罕见的肿瘤。由于其症状不具特异性,诊断困难。然而,术前早期诊断是进行潜在治疗的唯一可能。
对4例术前和5例术后的CT检查以及3例术前和1例术后的磁共振成像(MRT)检查进行了评估,对照手术和组织学检查结果。
CT和磁共振成像均显示存在凸向管腔内的肿块,大多从肺动脉干连续延伸至外周肺动脉分支,血管充盈和扩张,肿瘤不均匀提示出血和坏死,以及肺内结节的出现。复发性肺动脉肉瘤具有血管外生长特点,类似于累及血管的肺癌。它在CT和磁共振成像中均表现为强化,而原发性肿瘤仅在钆喷酸葡胺增强磁共振成像中表现出明显强化,在CT中无强化或强化不明显。
所介绍的CT和磁共振成像知识中的标准有助于提高术前正确诊断的概率,从而实现充分的手术规划。