De Potter Bruno, Huyskens Jef, Hiddinga Birgitta, Spinhoven Maarten, Janssens Annelies, van Meerbeeck Jan P, Parizel Paul M, Snoeckx Annemie
Department of Radiology, University Hospital Antwerp and University of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium.
Department of Thoracic Oncology, University Hospital Antwerp and University of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium.
Insights Imaging. 2018 Aug;9(4):463-476. doi: 10.1007/s13244-018-0605-6. Epub 2018 Apr 11.
Lung cancer patients often experience potentially life-threatening medical urgencies and emergencies, which may be a direct or indirect result of the underlying malignancy. This pictorial review addresses the most common thoracic, neurological and musculoskeletal medical emergencies in lung cancer patients, including superior vena cava syndrome, pulmonary embolism, spontaneous pneumothorax, cardiac tamponade, massive haemoptysis, central airway obstruction, oesophagorespiratory fistula, malignant spinal cord compression, carcinomatous meningitis, cerebral herniation and pathological fracture. Emphasis is placed on imaging findings, the role of different imaging techniques and a brief discussion of epidemiology, pathophysiology and therapeutic options. Since early diagnosis is important for adequate patient management and prognosis, radiologists have a crucial role in recognising and communicating these urgencies and emergencies.
• Multiplanar multidetector computed tomography is the imaging examination of choice for thoracic urgencies and emergencies. • Magnetic resonance imaging is the imaging modality of choice for investigating central nervous system emergencies. • Urgencies and emergencies can be the initial manifestation of lung cancer. • Radiologists have a crucial role in recognising and in communicating these urgencies/emergencies.
肺癌患者常经历可能危及生命的医学急症,这可能是潜在恶性肿瘤的直接或间接结果。本图像综述探讨了肺癌患者最常见的胸部、神经和肌肉骨骼医学急症,包括上腔静脉综合征、肺栓塞、自发性气胸、心脏压塞、大量咯血、中央气道阻塞、食管气管瘘、恶性脊髓压迫、癌性脑膜炎、脑疝和病理性骨折。重点介绍影像学表现、不同成像技术的作用,并简要讨论流行病学、病理生理学和治疗选择。由于早期诊断对患者的充分管理和预后很重要,放射科医生在识别和传达这些急症方面起着关键作用。
• 多平面多探测器计算机断层扫描是胸部急症的首选成像检查。• 磁共振成像(MRI)是调查中枢神经系统急症的首选成像方式。• 急症可能是肺癌的初始表现。• 放射科医生在识别和传达这些急症方面起着关键作用。