A Study On The Resectability Of Central Type Lung Cancer With Multislice Spiral CT: Correlation Of Imaging Features, Pathologic And Surgical Findings

OBJECTIVE To assess the accuracy of multislice spiral CT(MSCT) with imaging reconstruction in judging central pulmonary vascular and bronchial involvement from central lung cancer, to explore the ability of MSCT in foreseeing the resectability of lung cancer, and to evaluate the clinical application of CT virtual endoscopy(CTVE).METHODS MSCT was done in 38 patients who were diagnosed preoperatively as having central lung cancer. Contrast medium was injected at a rate of 3ml/sec with a power injector. The scaning delay was from 20 to 40 seconds. We used 120kV, 50mA, 2.5mm collimation and pitch 6:1 to produce 2.5mm thick image at 1.0mm increments. Images of pulmonary arteries, veins and bronchi that might affect lobectomy or pneumonectomy were reconstructed by means of imaging processing techniques such as shaded surface display (SSD), maximum intensity projection (MIP), curved planar reformation (CPR), multi-planar reformation (MPR), volume rendering(VR), and CTVE. Then the relation between tumor and vessels, bronchi were assessed prospectively on both axial CT and CT with imaging reconstruction in comparison with subsequent pathologic and surgical findings. And we also compared the ability of CT with imaging reconstruction and axial CT in foreseeing the dissectability of pulmonary vessels and the resectability of lung cancer.RESULTS ㎝SCT were obtained in all 38 patients. 32 of them underwent fiberoptic endoscopy, 30 underwent thoracotomy, lobectomy or pneumonectomy. 〤ompared with axial CT images, CT with imaging reconstruction was more accurarte in judging the relation of central pulmonary vessels and tumor (0.01