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Многосрезовая компьютерно-томографическая ангиография в определении внутригрудного распространения центрального рака легкого

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Multislice Computed Tomographic Angiography in Assessment of the Central Lung Cancer Mediastinal Invasion

The aim of our study was to evaluate the role of Multislice Computed Tomographic Angiography (MCTA) in assessment of the central lung cancer mediastinal invasion, planning an adequate surgical treatment tactics and correlation of MCTA and intraoperative data. 169 patients suffering from the central lung cancer were examined in the Institute of Medical Radiology from 2001 to 2005 (MCTA was performed on the Somatom Sensation Cardiac16 Siemens, Germany). 91 (53.8%) cases were considered by MCTA to be inoperable because of the cancer mediastinal invasion. Surgical treatment was performed to78 (46.2%) patients: pulmonectomy-44, bylobectomy-22, lobectomy-11 and thoracotomy –1. MCTA criteria of central lung cancer mediastinal invasion: absence of the mediastinal fat between the tumor mass and mediastinal structure, contact with the mediastinum of more than 3 cm, contact with aorta of more than 90О, pleural and pericardial thickening, deformation of the left atrium, local narrowing of the pulmonary artery of more than 24mm, the irregular margins of its internal wall, total obturation of pulmonary artery with the tumor masses. MCTA has great possibilities in evaluation of the central lung cancer relationship with adjacent structures and its mediastinal invasion degree. The method provides precise preoperative information regarding pulmonary vessels, aorta, superior vena cava, main bronchi and pericardium, besides, primary tumor and its intrathoracic invasion can be estimated. The early and precise diagnosis can be helpful in planning an adequate surgical treatment tactics which provides the improvement of the disease prognosis. Owing to the multiple possibilities inherent to this technique, MCTA could be considered as the technique of choice in the preoperative work-up.

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