Batra P, Brown K, Steckel R
Am J Surg. 1987 Jun;153(6):517-24. doi: 10.1016/0002-9610(87)90146-2.
For the early detection of lung cancer at a stage when it is localized and hence resectable, persons in a high-risk group should be screened periodically with sputum cytologic studies and chest radiographs. For determination of the intrathoracic extent of a lesion, posteroanterior and lateral chest radiographs should be followed by computerized tomography to evaluate the hila, mediastinum, pleura, and chest wall. Computerized tomographic examination of the chest should be extended to include the upper abdomen. The adrenal glands can be evaluated by such examination, but adequate examination of the liver requires both precontrast and postcontrast computerized tomography scans. The radiologic workup for assessing distant metastases to the liver, brain, or bone should be performed only when clinical and biochemical findings suggest such metastases. For detection of recurrent carcinoma following treatment, computerized tomograms of the chest are more sensitive than routine radiographs. Magnetic resonance imaging may prove useful in the future for initial staging and for differentiating posttreatment fibrosis from recurrent bronchogenic carcinoma.
为了在肺癌局限且可切除的阶段进行早期检测，高危人群应定期进行痰细胞学检查和胸部X光片筛查。为了确定病变的胸内范围，在前后位和侧位胸部X光片之后，应进行计算机断层扫描以评估肺门、纵隔、胸膜和胸壁。胸部计算机断层扫描检查应扩展至包括上腹部。肾上腺可通过此类检查进行评估，但对肝脏进行充分检查需要进行对比剂前和对比剂后的计算机断层扫描。仅当临床和生化检查结果提示存在转移时，才应进行评估肝脏、脑或骨远处转移的放射学检查。对于治疗后复发癌的检测，胸部计算机断层扫描比常规X光片更敏感。磁共振成像未来可能在初始分期以及区分治疗后纤维化与复发性支气管源性癌方面发挥作用。
