泛影葡胺—云南白药胶浆选择性支气管灌注对支气管扩张症咯血的治疗及造影作用初探

目的　探讨泛影葡胺－云南白药胶浆选择性支气管灌注对支气管扩张症咯血的治疗作用及其造影效果。方法　将３０例经临床、胸片和纤维支气管镜诊断为支气管扩张症的慢性反复咯血患者,随机分为实验组和对照组各１５例,分别作泛影葡胺一云南白药胶浆选择性支气管灌注治疗和造影,或仅作内科保守治疗,分别随访５年。结果　实验组１５例造影全部成功;其止血效果及５年内复发情况均好于对照组（Ｐ＜０．０５）。结论　泛影葡胺－云南白药胶浆对支气管扩张症咯血有明显的止血作用和缓解复发作用,同时也是一种较理想的支气管造影剂,具有进一步研究发展的可行性。     

Endobronchial carcinoid in a child: depiction with three-dimensional volume rendering

Endobronchial carcinoid is an extremely rare neoplasm in children. We report a case in which this entity was prospectively diagnosed by 3-D CT bronchography with volume rendering techniques. The ability to prospectively implicate an endobronchial neoplasm in a child may help to guide subsequent therapy and management.     

肺支气管血管CT三维重建辅助胸腔镜下解剖性肺段或亚段切除术前定位的应用效果观察

目的 探讨肺支气管血管CT三维重建（3D-CTBA）在单孔胸腔镜（VATS）解剖性肺段或肺亚段切除术前定位中的可靠性与临床效果。方法 回顾性研究。纳入2020年1月—2022年2月在徐州市中心医院胸外科行3D-CTBA辅助单孔VATS解剖性肺段或肺亚段切除术的肺结节患者207例。其中男78例、女129例,年龄27~93（57.4±11.7）岁,肺结节最大径0.2~4.3（1.1±0.6）cm。依据术前3D-CTBA影像解剖的定位和设计进行手术。观察指标：（1）围术期及术后随访情况;（2）评价3D-CTBA无创定位肺结节的可靠性。结果 （1）患者手术均顺利完成,均R0切除,无中转开胸。手术时间（131.4±59.7）min,术中出血量（92.6±76.6）mL。引流管留置时间（4.5±2.4）d。术后并发症发生率5.8%（12/207）,其中持续肺漏气（>7 d）6例、切口脂肪液化2例、乳糜胸2例、迟发性胸腔积液2例。术后30 d无二次手术。患者均获随访2~34（16.1±7.3）个月,无肿瘤复发或死亡。（2）术中解剖观察与术前3D-CTBA对比,切除的肺结节所在肺段或肺亚段的血管、支气管及其分支均与影像所示的解剖结构匹配。所有靶区肺结节完整切除且有明确的病理诊断,与影像定位相符。结论 3D-CTBA用于单孔VATS解剖性肺段或亚段切除术的手术前定位精准可靠,临床效果满意。     

The “horseshoe” lung: Six new cases

Six cases of horseshoe lung have been found in a group of 147 scimitar syndrome cases collected in a cooperative multicenter study. These cases were associated either with the severe infantile or with the benign adult form of the scimitar syndrome. The aim of this paper is to describe the clinical and imaging signs as well as the prognosis of 6 new cases of horseshoe lung in association with scimitar syndrome. The authors conclude (1) that the diagnosis of horseshoe lung may be strongly suspected on standard chest radiographs and confirmed by thoracic CT scan; (2) that the prognosis of scimitar syndrome does not seem to be worse when associated with horseshoe lung. Pediatr Pulmonol. 1994; 17:124–130 . © 1994 Wiley-Liss, Inc.     

细支气管肺泡癌的X线诊断（附45例分析）

目的：提高对肺泡癌的认识和诊断水平。材料与方法：总结分析了４５例经纤维支气管镜、手术病理证实的肺泡癌的临床与Ｘ线表现。结果：根据病灶的Ｘ线表现，分为结节型、炎症型和弥漫型三种。结论：肺泡癌较易延误诊断，但只要提高警惕，加强对本病的认识，紧密结合临床，对多数患者是能及时作出诊断的。     

碘水数字减影支气管造影对支气管扩张的临床应用

目的：评价三种浓度碘水混悬液在支扩患者数字减影支气管造影中的应用效果。方法：４０例临床诊断为支扩的患者被随机分成三组,分别用三种不同浓度造影剂作数字减影支气管造影,观察其成像质量及患者的副反应。结果：２０％、４０％浓度组具有满意的支气管成像质量;２０％、１０％浓度组患者具有较小的副反应。结论：选择２０％碘水混悬液作为数字减影支气管造影是支扩患者较理想的检查方法     

A modified system for classifying the bilateral superior pulmonary veins using three-dimensional computed tomography bronchography and angiography images

BackgroundIdentifying the distribution of pulmonary veins with three-dimensional reconstruction images is of great significance for surgical guidance. Existing models neglect the consistency of the bilateral superior pulmonary veins (SPVs) and lack a simple unified classification pattern. This study aimed to analyze the distributional features of bilateral SPVs, based on a cohort of patients undergoing CT examination.MethodsThe three-dimensional computed tomography bronchography and angiography (3D-CTBA) images of 1,520 cases were retrospectively analyzed. The reconstructed images of the right upper lobes were read in 715 cases, and left upper lobes in 805 cases. Through symmetrical analysis, the circulation of main venous branches and the spatial relationships of confluences with adjacent bronchus were compared.ResultsThe SPVs of bilateral upper lobes showed common distributional features and were divided into three main types. The central vein type, the semi-central vein type, and the non-central vein type accounted for 83.35% [596], 7.84% [56], 8.11% [58] of the 715 cases with right scanning, and 25.71% [207], 62.61% [504], 10.81% [87] of the 805 cases with left scanning, respectively. There were 5 (0.70%) cases with rare variations in the right upper lobe and 7 (0.87%) in the left upper lobe. The attribution of intersubsegmental vein in the posterior segment (V²b) and its position relative to the anterior segmental bronchus (B³) was the basis of classification in the right upper lobe, and the attribution of intersubsegmental vein in the apicoposterior segment (V¹⁺²c) and its position relative to B³ was the basis of classification in the left upper lobe. In this classification system, the branching pattern of the intersegmental vein between the apical segment and the anterior segment (V¹b) in the right upper lobe, and the intersegmental vein between the apicoposterior segment and the anterior segment (V^{1+ 2}a) in the left upper lobe were used for subdivision.ConclusionsOur modified system had a high degree of consistency in classifying SPVs in bilateral upper lobes, thus providing guidance for preoperative and intraoperative procedures.     

Braided bronchus: A previously undescribed airway anomaly

Infants with congenital heart disease frequently experience recurrent atelectasis, in many cases associated with anomalous branching of the bronchial tree. The bridging bronchus has been well described and has been associated with both left-sided obstructive lesions and a sling-like left pulmonary artery. We describe a similar, though distinct airway anomaly, the “braided bronchus,” associated with a bridging bronchus in a child with coarctation of the aorta and recurrent atelectasis. Methods used to delineate the “braided bronchus” are described. Pediatr Pulmonol. 1998; 25:348–351. © 1998 Wiley-Liss, Inc.     

Evaluation of the role of MSCT airway mapping in guiding trans-bronchial lung biopsy in cases of inaccessible lung lesions

Objective

This work aimed for using multislice computed tomography (MSCT) to map the bronchial tree and assess the exact site, direction, airway findings and bronchial measurements to guide trans-bronchial lung biopsy from an inaccessible lung lesion.

泛影葡胺胶浆支气管造影500例临床应用

目的：评价泛影葡胺胶浆造影剂对气管造影的显影效果。方法：500例支气管造影中，男346例，女154例，年龄5－71岁，平均42岁，单侧85例，造影剂用量为10－15ml，双侧415例，用量为20－30ml。结果：肺叶、肺段、亚段支气管及分支显影良好487例，占97.4％，无咳嗽反应456例，占91.2%。结论：泛影葡胺胶浆是一种较为理想的支气管造影剂，可取代碘化油和丙碘酮等。