Präuer H W, Helmberger H, Weber W
Sektion Thoraxchirurgie, Klinikum rechts der Isar, Technischen Universität München.
Radiologe. 1998 Apr;38(4):256-62. doi: 10.1007/s001170050352.
In addition to conventional chest X-rays in AP and lateral projection, computed tomography of the chest, upper abdomen, and head, precutaneous ultrasonography of the abdomen, and bone scintigraphy represent the standard procedures for the primary diagnosis and staging of bronchial carcinoma. Magnetic resonance imaging should be reserved for special situations and patients with allergy to i.v. contrast medium. The clinical value of positron emission tomography (PET) primarily with respect to lymph-node staging is currently being evaluated in ongoing studies. Due to the high sensitivity of the listed staging modalities in combination with rather low specificity, there is a general tendency towards "over staging", which carries certain risk particularly for potentially operable patients. Consequently the criteria which indicate inoperability (T3, T4, N2, N3 and, in individual cases, M1) have to be confirmed histologically by biopsy employing interventional techniques or even by explorative thoracotomy before definite therapeutic decisions are made.
除了常规的前后位和侧位胸部X线检查外，胸部、上腹部和头部的计算机断层扫描、腹部经皮超声检查以及骨闪烁扫描是支气管癌初步诊断和分期的标准程序。磁共振成像应保留用于特殊情况以及对静脉造影剂过敏的患者。目前正在进行的研究中评估正电子发射断层扫描（PET）主要在淋巴结分期方面的临床价值。由于所列分期方式的高敏感性与相对较低的特异性相结合，普遍存在“过度分期”的趋势，这对潜在可手术的患者尤其有一定风险。因此，在做出明确的治疗决策之前，必须通过介入技术活检甚至通过探查性开胸手术进行组织学确认表明不可手术的标准（T3、T4、N2、N3以及个别情况下的M1）。
