Gückel C, Stulz P, Bolliger C T
Institut für Diagnostische Radiologie, Kantonsspital Basel, Universitätskliniken.
Aktuelle Radiol. 1995 Mar;5(2):79-86.
Imaging methods, especially CT and for specific questions MRI, are an essential part of diagnosis and staging of non-small cell lung cancer. They are effective methods for the detection of unresectable tumours and avoid the necessity for further invasive examinations and explorative thoracotomies. The judgement of lymph node size by CT suffers from a limited accuracy. Nevertheless, it allows guided bronchoscopical staging biopsies of enlarged mediastinal lymph nodes (> 1 cm) and, therefore, a selective indication of mediastinoscopy. CT scans of the thorax usually are extended to the adrenal glands and the liver to exclude metastasis. Extrathoracic scanning beyond the upper abdomen and bone scintigraphy should be restricted to patients with clinical indicators or symptoms. The combined application of imaging methods, bronchoscopy, and mediastinoscopy provides better selection of surgical candidates and hence reduces the rate of unresectable operations.
成像方法,尤其是CT以及针对特定问题的MRI,是非小细胞肺癌诊断和分期的重要组成部分。它们是检测不可切除肿瘤的有效方法,避免了进一步进行侵入性检查和探索性开胸手术的必要性。通过CT判断淋巴结大小的准确性有限。然而,它可以指导对肿大的纵隔淋巴结(>1 cm)进行支气管镜分期活检,因此,可作为纵隔镜检查的选择性指征。胸部CT扫描通常会扩展至肾上腺和肝脏以排除转移。超出上腹部的胸外扫描和骨闪烁扫描应仅限于有临床指征或症状的患者。成像方法、支气管镜检查和纵隔镜检查的联合应用能更好地筛选手术候选者,从而降低不可切除手术的发生率。