MSCT支气管动脉三维成像对中心型肺癌的血供研究及其临床意义

目的探讨多层螺旋CT(MSCT)三维支气管动脉成像在中心型肺癌中的影像学表现及应用价值,为中心型肺癌的血供来源和介入治疗提供理论依据。方法对18例中心型肺癌的病人行MSCT造影增强检查,采用实时螺旋薄层CT扫描,在独立工作站行支气管动脉三维重建,使用不同的旋转轴观察支气管动脉的空间解剖细节。结果其中6例(33．33％)中心型肺癌的支气管动脉三维图像能够清晰显示出去支气管动脉的起源、走行的路径(肺内段和纵隔段)和血管直径等情况。有肺动脉明显狭窄截断的病例支气管动脉显示率最高,且明显增粗,表明此类肺癌的血供来源主要以支气管动脉为主。兰维成像中以容积显示技术(SVR像)显示最佳。结论MSCT三维支气管动脉成像能够准确、直观地显示支气管动脉的空间解剖特点,为中心型肺癌的血供研究与介入治疗提供理论基础。

Three-dimensional Imaging of Multi-slice Spiral CT in Bronchial Artery Correlative Study on Blood Supply of Central Lung Cancer and Its Clinical Significance

Objective: To evaluate three-dimensional bronchial artery imaging characters in central lung cancer and applied values with multi-slice spiral CT (MSCT) to provide theoretical evidence on blood supply and intervention therapy. Methods: Eighteen patients with central lung cancer underwent MSCT with real time helical thin-slice CT scanning. Three-dimensional bronchial artery reconstruction was done at the console work-station. The space anatomical characters of bronchial artery were observed through different rotations. Results: For 6 cases, the three-dimensional images of bronchial artery (33.33%) could exactly show the origins, the routes (lung inner segment and mediatism segment) and the diameters of bronchial arteries. Vision rate of bronchial arteries was the highest in pulmonary artery stricture and truncation groups, and the vessels diameter became larger apparently. These characters demonstrated blood supply of this kind of central lung cancer come from bronchial artery. Volume rendering images were the best ones among three-dimensional images. Conclusion: Three-dimensional imaging with MSCT in bronchial artery can reveal the anatomical characters of bronchial artery and provide theoretical evidence on blood supply and intervention therapy of central lung cancer.