Storto M L, Ciccotosto C, Mucilli F, Sacco R, Bonomo L
Istituto di Scienze Radiologiche, Università, Chieti.
Radiol Med. 1991 Sep;82(3):275-80.
In order to plan an adequate treatment, it is very important to recognize the transfissural spread of lung cancer near a pleural fissure, especially in the patients who cannot bear pneumonectomy because of impaired pulmonary function. Fifteen patients with lung cancer near a fissure were examined by means of conventional CT (10 mm-thick slices) followed by high-resolution CT (HRCT). The results obtained with both techniques were compared with surgical findings. At surgery, major fissure involvement was seen in 12 cases, minor fissure was involved in 3, and 2 patients were normal. In 4 cases fissural involvement was correctly demonstrated by conventional CT scans. Neoplastic involvement of the major fissure was identified in 13 cases by HRCT scans, with only 1 false positive. Pleural fissures appear as thin and sharp lines on HRCT scans. Thus, the relationship of lung cancers to fissures is better identified and the accuracy of the method in defining neoplastic spread is higher. However, the relationship of a neoplastic mass to the minor fissure is difficult to evaluate, because the fissure is roughly parallel to the scanning plane.
为了制定恰当的治疗方案，识别胸膜裂附近肺癌的跨裂蔓延非常重要，尤其是对于因肺功能受损而无法耐受肺切除术的患者。对15例靠近肺裂的肺癌患者先进行常规CT（层厚10毫米）检查，然后进行高分辨率CT（HRCT）检查。将两种技术的检查结果与手术所见进行比较。手术中，12例可见主裂受累，3例次裂受累，2例正常。常规CT扫描正确显示4例裂受累情况。HRCT扫描识别出13例主裂肿瘤受累，仅1例假阳性。在HRCT扫描上，胸膜裂表现为细而清晰的线。因此，肺癌与肺裂的关系能更好地被识别，且该方法在界定肿瘤蔓延方面的准确性更高。然而，肿瘤块与次裂的关系难以评估，因为该裂大致与扫描平面平行。
