Preoperative evaluation of digital subtraction pulmonary angiography in primary lung cancer

The preoperative evaluation of the resectability for primary lung cancer was studied by using digital subtraction pulmonary angiography (DSA-PAG). Thirty operative cases with primary lung cancer performed DSA-PAG as preoperative test at random for 3 years from June 1985 were subjected in this study. The apparatus used in DSA device (Angiotoron) of a product of Siemens Co., Ltd. The findings obtained by DSA-PAG were retrospectively studied according to the surgical findings, operative modes and postoperative histopathological findings. Moreover, at the same time, usefulness of DSA-PAG was evaluated comparing its findings with preoperative enhanced CT interpretation. The useful findings were obtained in 10 cases of 30 cases (33%). Its contents were 2 cases with invasion of the left atrium, 2 cases with invasion of superior and inferiro pulmonary vein, 5 cases with invasion of truncus pulmonary artery and 1 case with interlobar invasion. The findings in all cases were superior to those obtained by the enhanced CT. The decision of operative modes confirming invasion of tumor or metastatic lymph node is one of the important aims of the preoperative test. DSA-PAG can be carried out simply and safely on out-patient basis, additionally, favorable result can be especially obtained in invasion lesions of blood vessels of hilus regions. From the result, informations of regions unknown by preoperative CT was accurately obtained. As a rule, DSA-PAG should be performed by the preoperative routine test of primary lung cancer. (author)