Diagnosis of pulmonary diseases Radiologic-pathologic collelation

肺部疾病的诊断放射学-病理学比对

基本信息

批准号：
09670929
负责人：
ITOH Harumi
金额：
$ 1.28万
依托单位：
Fukui Medical University (1999)Kyoto University (1997-1998)
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1997
资助国家：
日本
起止时间：
1997 至 1999
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09670929/
关键词：
lung cancer HRCT pleural indentation subpleural lymphatics diffuse lung disease secondary lobule centriacinar emphysema 3-D CTP 高分解能CT 3DCT 画像・病理対応 3次元CT 間質性肺炎伸展固定肺三次元CT 肺がん放射線・病理対応

项目摘要

The purpose of the study was to do precise correlation between CT and lung specimens obtained by operation. The study was performed by collaborations among departments of radiology, respiratory surgery and pathology. High resolution CT and helical scan with 3D-CT were taken in patients with lung cancer and diffuse pulmonary diseases. The informations obtained during operation were important to do pertinent correlation. Lung specimens were inflated with air or liquid formaline. CT and radiography were taken from the air-filled lung specimens. Stereo-microscopy was useful to observe fine pulmonary structures and pathologic lesions in sliced lung specimens.A new finding was observed regarding pleural indentation. The visceral pleura and tumor attached each other was separated from the chest wall and covered by overinflated adjacent lungs. Preoperative CT of such condition showed sharp and caved tumor-lung intereface. In addition, several linear attenuations radiating from the tumor to the chest wall were shown, suggesting pleural indentation. Ground glass attenuation seen in CT corresponded to thickening of alveolar wall due to tumor invasion, which was seen clearly with stereomicroscope.Subpleural lymphatic vessels were demonstrated by high resolution and helical CT from the air-filled lung specimens. Three dimensional CT of pleural surface showed subpleural lymphatic networks. with polygonal appearance. The thick lymphatics were located with interlobular septum and seen connected to lung parenchyma with linear opacity. The subpleural lymphatics were not visualized with in vivo CT because of lack of contrast.Small pulmonary vessels attached to early centriacinar emphysema proved intralobular pulmonary artery. Since the pulmonary vessels whose diameter was bigger than 1mm were located between the secondary lobules, these vessels did not connect to small centriacinar emphysema .in CT.

该研究的目的是在CT和手术获得的肺标本之间建立精确的关联。该研究是由放射科、呼吸外科和病理科合作进行的。对肺癌和弥漫性肺部疾病患者进行了高分辨率 CT 和 3D-CT 螺旋扫描。操作过程中获得的信息对于进行相关关联很重要。肺部标本用空气或液体福尔马林充气。 CT 和射线照相是从充满空气的肺部标本中进行的。体视显微镜有助于观察肺切片标本中的精细肺结构和病理病变。观察到胸膜凹陷的新发现。相互附着的脏层胸膜和肿瘤与胸壁分离，并被过度膨胀的相邻肺部覆盖。这种情况的术前CT显示肿瘤-肺界面清晰且凹陷。此外，还显示了从肿瘤辐射到胸壁的几个线性衰减，表明胸膜凹陷。 CT中看到的毛玻璃衰减对应于肿瘤侵袭导致的肺泡壁增厚，这在立体显微镜下可以清楚地看到。通过高分辨率螺旋CT从充满空气的肺标本中显示胸膜下淋巴管。胸膜表面三维CT显示胸膜下淋巴网络。具有多边形外观。粗大淋巴管位于小叶间隔处，与肺实质相连，呈线状混浊。由于缺乏对比，体内CT无法显示胸膜下淋巴管。早期中心型肺气肿附着的小肺血管证实为小叶内肺动脉。由于直径大于1mm的肺血管位于次级小叶之间，这些血管在CT上并不与小泡中心性肺气肿相连。