To explore the pulmonary-vascular-stump filling-defect on CT and investigate its association with cancer progression. Records in our institutional database from 2018 to 2022 were retrospectively analyzed to identify filling-defects in the pulmonary-vascular-stump after lung cancer resection and collect imaging and clinical data of patients. Among the 1714 patients analyzed, 95 cases of filling-defects in the vascular stump after lung cancer resection were identified. After excluding lost-to-follow-up cases, a total of 77 cases were included in the final study. Morphologically, the filling-defects were dichotomized as 46 convex-shape and 31 concave-shape cases. Concave defects exhibited a higher incidence of increase compared to convex defects (51.7% v. 9.4%, P = 0.001). Among 61 filling defects in the pulmonary arterial stump, four (6.5%) increasing concave defects showed the nuclide concentration on PET and extravascular extension. The progression-free survival (PFS) time differed significantly among the concave, convex, and non-filling-defect groups (log-rank P < 0.0001), with concave defects having the shortest survival time. Multivariate Cox proportional hazards analysis indicated that the shape of filling-defects independently predicted PFS in early onset on CT (HR: 0.46; 95% CI: 0.39–1.99; P = 0.04). In follow-ups, the growth of filling-effects was an independent predictor of PFS (HR: 0.26; 95% CI: 0.11–0.65; P = 0.004). Certain filling-defects in the pulmonary-arterial-stump post lung tumor resection exhibit malignant growth. In the early onset of filling-defects on CT, the concave-shape independently predicted cancer-progression, while during the subsequent follow-up, the growth of filling-defects could be used independently to forecast cancer-progression.

中文翻译：

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肺肿瘤切除术后 CT 上的肺血管残端充盈缺损：癌症进展的预测因子


探讨 CT 上的肺血管残端充盈缺损并探讨其与癌症进展的关系。回顾性分析我们机构数据库中2018年至2022年的记录，以确定肺癌切除后肺血管残端的充盈缺损，并收集患者的影像和临床数据。在分析的 1714 名患者中，发现 95 例肺癌切除后血管残端充盈缺损。排除失访病例后，最终研究共纳入77例。从形态上看，充盈缺损分为凸形 46 例和凹形 31 例。与凸形缺陷相比，凹形缺陷的增加发生率更高（51.7% vs. 9.4%，P = 0.001）。在肺动脉残端的 61 个充盈缺损中，有 4 个（6.5%）增加的凹形缺损显示 PET 上的核素浓度和血管外延伸。凹形缺损组、凸形缺损组和非充盈缺损组的无进展生存期 (PFS) 存在显着差异（对数秩 P < 0.0001），其中凹形缺损组的生存时间最短。多变量 Cox 比例风险分析表明，CT 上充盈缺损的形状独立预测早期发病的 PFS（HR：0.46；95% CI：0.39–1.99；P = 0.04）。在随访中，填充效应的增长是 PFS 的独立预测因素（HR：0.26；95% CI：0.11–0.65；P = 0.004）。肺肿瘤切除后肺动脉残端的某些充盈缺损表现出恶性生长。在CT上的充盈缺损早期出现时，凹形可以独立预测癌症进展，而在随后的随访中，充盈缺损的增长可以独立地预测癌症进展。