多层螺旋CT多平面重建对支气管壁增厚的诊断价值及临床应用

目的　评价多层螺旋CT多平面重建对支气管壁增厚及显示能力的诊断与鉴别价值。方法　 5 0例拟诊中央型肺癌的患者行多层螺旋CT检查 ,采用直接增强扫描 ,在工作站得到支气管的多平面图像 (MPR) ,螺距 1 35 ,重建间隔 1mm ,重建层厚 1 2 5mm。其中 4 2例中央型肺癌与 6例支气管内膜结核及 2例支气管腔内良性病变均经病理证实。所有图像均由 2位放射科医师观察记录肺叶、段支气管管壁的厚度 (T)及管壁增厚的长度 (L)。结果　 (1)MPR 4 2例中央型肺癌的叶、段支气管管壁厚度平均为 14 5mm ,管壁增厚长度平均为 2 5 2mm ,其T/L比值为 0 5 8。 (2 )中央型肺癌支气管管壁厚度及管壁增厚长度MPR与横断面CT之间差异具有显著性意义 (分别为P <0 0 5、P <0 0 1)。(3) 6例支气管内膜结核T/L比值为 0 17。 (4 ) 4 2例中央型肺癌与 6例支气管内膜结核管壁厚度、管壁增厚长度及T/L比值差异有显著性意义 (分别为P <0 0 5、P <0 0 1、P <0 0 1)。结论 (1)螺旋CTMPR技术对支气管壁的显示是横断面CT的重要补充。 (2 )T/L比值有助于中央型肺癌的诊断与鉴别诊断。

Diagnostic value of multi-slice spiral CT with multi-planar reconstructions in the bronchial wall thickening and its clinical application

Objective To assess diagnostic and differential diagnostic value of multi-slice spiral CT with multi-planar reconstructions in the bronchial wall thickening and its demonstration.Methods Fifty patients including central lung cancer (n=42),endobronchial tuberculosis (n=6),and intrabronchial benign lesion (n=2) were performed on spiral CT examinations.All the final diagnosis was proved by pathology.All patients were performed on GE Lightspeed 99 scanner,using 10 mm collimation,pitch of 1.35,and reconstructed at 1 mm intervals and 1.25 mm thickness.The chest images were viewed by two radiologists separately.The observations and measurement included the bronchial wall thickness of bronchopulmonary segments (T) and the length of the bronchial thickened wall (L).Results (1) In 42 cases of central lung cancer,the mean T was 14.5 mm and the mean L was 25.2 mm.The T/L ratio was 0.58.(2) In central lung cancer,the thickness and the length of bronchial thickened wall on multi-planar reconstructions and traverse CT were markedly different(P<0.05,P<0.01,respectively).(3) The T/L ratio of 6 cases of endobronchial tuberculosis was 0.17 (4) The thickness,the length,and the T/L ratio of thickened wall due to central lung cancer and endobronchial tuberculosis were markedly different (P<0.05,P<0.01, and P<0.01,respectively).Conclusion Spiral CT with multi-planar reconstructions could provide additional information in demonstrating the bronchial thickened wall.The T/L ratio was helpful in the diagnosis and differential diagnosis of central lung cancer.