Müller N L, Nichols D M
Can Assoc Radiol J. 1987 Jun;38(2):82-6.
Detection of aortopulmonary window lymph node enlargement by chest radiography was assessed in 67 patients with bronchogenic carcinoma. All patients underwent computed tomography (CT). Surgical confirmation of the radiographic and CT findings was available in all patients with lymph node size smaller than 2.5 cm in diameter on CT (47 patients) and in 6 of 20 patients with nodes greater than 2.5 cm in diameter. Forty-one had normal-sized and 26 had enlarged (greater than 1.5 cm diameter) aortopulmonary nodes. Lymphadenopathy was detected on the chest radiograph in 21 of the 26 patients with enlarged nodes. It was wrongly suspected in one of the 41 patients with normal-sized aortopulmonary nodes on CT. Three patients with lymphadenopathy had a normal aortopulmonary window on the chest radiograph. In these patients, the nodes measured 1.6-2.6 cm in diameter. In two patients with enlarged nodes and in two with normal-sized nodes, the aortopulmonary window could not be assessed on the radiograph because it was obscured by concomitant atelectasis and obstructive pneumonitis of the left upper lobe. We conclude that in the absence of left upper lobe atelectasis, chest radiography has a high sensitivity (87%) and specificity (97%) in detecting aortopulmonary lymph nodes larger than 1.5 cm in diameter. In only one patient was metastatic disease detected at surgery in a node smaller than 1.5 cm diameter.
对67例支气管肺癌患者进行胸部X线检查，以评估主肺动脉窗淋巴结肿大情况。所有患者均接受了计算机断层扫描（CT）。对于CT显示淋巴结直径小于2.5 cm的所有患者（47例）以及20例淋巴结直径大于2.5 cm的患者中的6例，均可通过手术证实X线和CT检查结果。41例患者的主肺动脉淋巴结大小正常，26例患者的主肺动脉淋巴结肿大（直径大于1.5 cm）。26例淋巴结肿大的患者中，21例胸部X线片上检测到淋巴结病。CT显示主肺动脉淋巴结大小正常的41例患者中，有1例被误诊为淋巴结病。3例有淋巴结病的患者胸部X线片上主肺动脉窗正常。在这些患者中，淋巴结直径为1.6 - 2.6 cm。2例淋巴结肿大的患者和2例淋巴结大小正常的患者，由于左上叶合并肺不张和阻塞性肺炎，X线片无法评估主肺动脉窗。我们得出结论，在没有左上叶肺不张的情况下，胸部X线检查在检测直径大于1.5 cm的主肺动脉淋巴结方面具有较高的敏感性（87%）和特异性（97%）。仅1例患者手术时在直径小于1.5 cm的淋巴结中检测到转移性疾病。
