The Application Of Multi-slice Spiral CT For Diagnosis Of Primary Tumor In Central Airway

Objective:Multislice spiral computed tomography(MSCT)has been widely used in diagnosis of thoracic diseases.However,due to relatively lower incidence rate of central airway tumors,and the atypical clinical symptoms and signs,it was prone to result of misdiagnosis or missed diagnosis.By analyzing the original axial and various post processing image features of the central airway tumor,this study was to evaluate of the application value of MSCT in aspects of discovery and differential diagnosis on central airway lesions.Materials and methods:We retrospectively collected the medical records(clinical data and MSCT axial and various post-processing images)of 36 patients of central airway tumors with pathologic diagnosis.There were 24 males and 12 females with age range from 34 to 88 years.Twenty-seven cases were malignant:including squamous cell carcinoma in 10 cases,adenocarcinoma in 2 cases,adenosquamous cancer in 2 cases,adenoid cystic carcinoma in 5 cases,mucoepidermoid carcinoma in 3 cases,carcinoid in 2 cases,neuroendocrine carcinoma in 1 cases,fibrosarcoma in 1 cases,sarcomatoid carcinoma in 1 cases,while 9 cases were benign:including hamartoma in 5 cases,lipoma in 2 cases,solitary fibrous tumor in 1 cases,and neurilemmoma in 1 cases.Then using the post processing workstation,multi-planner reformation(MPR)?volume rendering(VR)?CT virtual bronchoscopy(CTVB)images were reconstruction and used to outline the lesion size,morphology,density,extent and secondary distal airway obstruction,and lymph node metastasis.Analysis was done between malignant and benign groups by using SPSS 19.0 statistical software system.P<0.05 was significantResult:1.All lesions were able to detect on the original axial images,MPR and VB images.2.The parameters of age,the lesion shape and length,wall thickening,lesion density were of great value for the differential diagnosis of the benign and malignant lesions.3.There was no significant difference between the enhanced features of the benign and malignant central airway tumors.However,the marked enhancement was suggestive of carcinoid tumors in neuroendocrine tumors.4.There was no significant difference in the extent of stenosis and obstruction between the benign and malignant central airway tumors groups.No lymph node metastases in benign tumor.Conclusion:1.Transverse,MPR,VR images,and combined application could accurately find the central airway tumors,outline the lesion boundary,shape,density,enhancement characteristics and secondary changes.2.There are some differences in the age of onset of central airway tumors,patients with benign lesions is relatively young.The length of central airway tumors had a certain significance between two groups.Benign lesions were limited,while malignant lesions were widely.The fat density in the lesion is of certain significance in the diagnosis of hamartoma.3.The benign primary focus of the central airway is mostly intracavitary nodules,and the malignant primary tumor is widely involved in the tracheal wall.4.There is no significant difference in enhanced features,secondary lung obstruction caused by benign or malignant tumors.However,enhancement MSCT was of certain value in the diagnosis of carcinoid tumors in central airway neuroendocrine tumors.5.MSCT was of positive significance in the differential diagnosis of central airway squamous cell carcinoma and adenoid cystic carcinoma.6.MSCT enhancement has a certain diagnostic value for the diagnosis of central airway carcinoid.