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[肺切除术后患者的CT表现]

[CT findings of post-pneumonectomy patients].

作者信息

Kobayashi H, Matsuoka R, Mieno T, Kitamura S, Take A, Yamamoto N, Fukushima K, Hayakawa K, Hata E

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1989 Sep;27(9):1046-52.

PMID:2585902
Abstract

CT findings following pneumonectomy were studied in 28 cases with lung cancer. A total of 53 CT images were evaluated in 13 right pneumonectomy cases and 15 left pneumonectomy patients. The postpneumonectomy pleural space (PS), thoracic space of the operated site (TS) and the thoracic space of the non-operated site (CTS) were measured at 3 slice levels of the brachiocephalic level, subcarinal level and lower pulmonary vein level, using a digital planimeter. There was no significant difference in the TS/CTS ratio, between the right pneumonectomy group and the left pneumonectomy group, but the PS/TS ratio in the left pneumonectomy group was smaller than that in the right pneumonectomy group (p less than 0.01). The PS/TS ratio in both groups and the TS/CTS ratio in the right pneumonectomy group were decreased with time. In the left pneumonectomy group, the TS/CTS ratio was greater in the median sternotomy group that of the posterolateral thoracotomy group (p less than 0.01). Residual pleural effusion was accompanied with a thin circulating lesion along the outer surface. This lesion had been reported as thickening of the parietal pleura, but it could be detected in the case of panpleuropneumonectomized state. Additionally, in some cases, the parietal pleural imaging could be separated from the circulating lesion. So, this structure was thought to be mainly composed of organized effusion. CT images could detect some parts of the episodes in post operated thorax, because of the lack of the information with the sagittal direction. However, the recognition of the common changes and images on CT after the operation might be helpful for the follow-up of the patients.

摘要

对28例肺癌患者肺切除术后的CT表现进行了研究。对13例右肺切除患者和15例左肺切除患者的53幅CT图像进行了评估。使用数字面积测量仪在头臂干水平、隆突下水平和肺下静脉水平的3个层面测量肺切除术后胸膜腔(PS)、手术部位胸腔(TS)和非手术部位胸腔(CTS)。右肺切除组和左肺切除组的TS/CTS比值无显著差异,但左肺切除组的PS/TS比值小于右肺切除组(p<0.01)。两组的PS/TS比值和右肺切除组的TS/CTS比值均随时间下降。在左肺切除组中,正中开胸组的TS/CTS比值大于后外侧开胸组(p<0.01)。残余胸腔积液伴有沿外表面的薄环形病变。该病变曾被报道为壁层胸膜增厚,但在全胸膜肺切除状态下也可检测到。此外,在某些情况下,壁层胸膜成像可与环形病变分离。因此,这种结构被认为主要由机化性积液组成。由于缺乏矢状方向的信息,CT图像只能检测到术后胸部病变的某些部分。然而,识别术后CT上的常见变化和图像可能有助于对患者进行随访。

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