Definition of boundary lines with diagnostic importance for lung cancer staging,demonstrated with CT and MRI and based on AJCC/ATS regional lymph node classification: A comparative study with cross-sectional anatomy
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摘要: 目的: 确定ATS/AJCC胸内淋巴结CT、MRI分区中一些重要界线。方法: 在5具尸体上观察胸内淋巴结分布,用胸部横断层标本(4套)与CT (50例)、MRI (20例)图像对照观察。确定了2条辅助线和2个影像解剖标志来区分4、5、6及10区淋巴结。结果: 在主动脉弓上缘至肺动脉干区段,经升主动脉断面圆心的冠状线分开5区与6区,升、降主动脉断面圆心间连线分开5区与4L (ATS、AJCC)或10L区(ATS)。左肺动脉分开5区与4L或(AJCC)10L区(ATS)。奇静脉弓分开4R区与10R区(ATS)或4R上、下组(AJCC)。结论: 文中设计的组间界线使ATS和AJCC分区系统易于使用,有利于肺癌准确的影像学分期。Abstract: Objective: To define several boundary lines with diagnostic significance for lung cancer staging,demonstrated with CT and MR imaging and according to ATS/AJCC regional lymph nodal classification.Methods: In 5 cadavers,intrathoracic lymph nodes were observed and classified using ATS and AJCC systems.Stations 4,5,6 and 10 were identified with 2 assisted lines and 2 imaging based anatomic landmarks by comparing CT and MR images with 4 series of cross sectional specimens.Results: In the segment from the superior border of aortic arch to the main pulmonary artery trunk,a coronal line through the sectional center of the ascending aorta divided Stations 5 and 6.The line between the centers of ascending and descending aorta separated Station 5 from Station 4 L(ATS,AJCC),or 10L(ATS) on axial images.The left pulmonary artery separated Station 5 from 10L(ATS),or 4L(AJCC) and the arch of azygos vein separated Station 4R from 10R(ATS),or superior and inferior subset of 4R(AJCC).Conclusions: The boundary lines between the stations designed in our study facilitate the application of ATS and AJCC classification system,which is helpful to lung cancer staging with CT and MR imaging.
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