支气管三维重建和仿真内窥镜的应用价值和限度

目的 研究ＣＴ支气管三维重建和仿真支气管内窥镜的临床应用价值和限度。方法 １０例正常志愿者和５２例病人，行薄层双螺旋ＣＴ容积扫描后将图像传输至工作站并进行多层面／曲面重建（ＭＰＣ／ＣＰＲ），最小密度投影加气管曲面断层，三维（３Ｄ）重建和仿真支气管内窥镜成像（ＶＲ），比较４种后处理方法对气道显示的差异和发现病变的敏感性及特异性等。

Virtual bronchoscopy and bronchotracheal 3 dimensional reconstruction: value and limitation

Objective To study the value and limitation of bronchotracheal 3 dimensional reconstruction(3D) and virtual bronchoscopy(VB) Methods Ten normal volunteers and 52 patients underwent thin slice double helical CT scan Images were transferred to Omnipro workstation and 4 kinds of postprocessing including multiple/curved planar reconstruction (MPR/CPR), minimum intensity projection plus MasterCut (MinIP CPR), 3 dimensional reconstruction and virtual bronchoscopy were performed The differences of airway appearances and measurements, diagnostic sensitivity and specificity for bronchotracheal lesions of the 4 methods were compared Results (1)Four kinds of postprocessing were able to demonstrate segmental even subsegmental bronchial divisions (2) 3D and VB presented the morphology of airway and airway lesions in a vivid way in a way similar to endoscopy (3) There were inaccuracies in the measurement of lobar and segmental bronchi of normal volunteers with 3D and VB (4) The sensitivities of MPR(CPR), MinIP CPR, 3D and VB for detecting bronchotracheal lesions were 90 0%, 80 0%, 60 0% and 55 0%,and specificities were 90 9%, 81 8%, 72 7% and 63 6%, respectively Conclusions (1) With direct, vivid and continuous display modes, 3D and VB are helpful in understanding of morphology of disorders and suitable for teaching (2) There are inaccuracies in 3D and VB assessment, and the sensitivity and specificity for detection of bronchotracheal lesions are not improved by using 3D and VB