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[肺数字减影血管造影术在评估肺肿瘤可切除性中的意义]

[Significance of pulmonary DSA for assessing the operability of lung tumors].

作者信息

Arlart I P, Lampl L, Bargon G

出版信息

Rofo. 1985 Sep;143(3):261-8. doi: 10.1055/s-2008-1052805.

Abstract

In lung tumours histological findings, exclusion of metastatic disease and different diagnostic procedures such as bronchoscopy, mediastinoscopy and thoracic CT play an important role for tumour staging to plan the correct therapeutic approach. Selection of patients for thoracotomy depends on results of these examinations. This study was carried out to assess the value of an additionally applied pulmonary DSA in 17 patients with lung tumours (bronchogenic carcinoma n = 14). Our results demonstrate that in 4 cases angiography could prove inoperability of tumours (compression of sup. v. cava, occlusion of a main pulmonary artery): one patient had a negative mediastinoscopy, one patient had a small cell bronchogenic carcinoma; in two patients an additional mediastinoscopy could be omitted. In two other patients with bronchogenic carcinoma who appeared operable in mediastinoscopy and DSA, explorative thoracotomy only could ensure inoperability due to an infiltration of the thoracic wall. As a minimal invasive method applicable in outpatients pulmonary DSA seems to be useful in giving additional important diagnostic information particularly in central bronchogenic carcinomas.

摘要

在肺部肿瘤的组织学检查结果中,排除转移性疾病以及诸如支气管镜检查、纵隔镜检查和胸部CT等不同的诊断程序,对于肿瘤分期以规划正确的治疗方法起着重要作用。选择进行开胸手术的患者取决于这些检查的结果。本研究旨在评估额外应用的肺部数字减影血管造影(DSA)在17例肺部肿瘤患者(其中14例为支气管源性肺癌)中的价值。我们的结果表明,在4例患者中,血管造影可证实肿瘤无法手术切除(上腔静脉受压、主肺动脉闭塞):1例患者纵隔镜检查结果为阴性,1例患者为小细胞支气管源性肺癌;在2例患者中,可省略额外的纵隔镜检查。在另外2例支气管源性肺癌患者中,纵隔镜检查和DSA显示似乎可手术,但仅通过探查性开胸手术才能确定由于胸壁浸润而无法手术。作为一种适用于门诊患者的微创方法,肺部DSA似乎有助于提供额外的重要诊断信息,尤其是对于中央型支气管源性肺癌。

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