Possibility of determining the degree of adhesion of the lymph node to the pulmonary artery preoperatively

Hidetaka Uramoto, Satoshi Nozu, Yuki Nakajima, Hiroyasu Kinoshita

To make a preoperative determination of the degree of adhesion of the lymph node (LN) to the pulmonary artery (PA) in patients with lung cancer. We investigated clinical parameters, including sex, age, smoking, stage, histology and surgical procedure, and performed an image analysis using CT scanning. The data for sex, age, smoking, stage, histology and the surgical procedure were identical between the "adhesion" and "no adhesion" groups. However, three of the five analyzable cases in the adhesion group clearly showed the disappearance of the fat plane on minimum intensity projection (minIP) computed tomography (CT). In particular, sites on more than three slices demonstrated the disappearance of the fat plane. On the other hand, five of the eight analyzable cases in the no adhesion group showed no disappearance of the fat plane. Therefore, one central slice adequately reflected the fat plane in the cases in the no adhesion group. These findings suggest that it is necessary to obtain a careful diagnosis of the extent of attachment of the LN to the PA using modern diagnostic imaging in order to preoperatively assess the degree of adhesion of the LN to adjacent structures.