SPECT/CT肺灌注显像中肺段精确定位方法的研究

目的 研究SPECT/CT肺灌注显像中肺段横断面、矢状面及冠状面的精确定位方法.方法 分析12名健康成人的肺灌注断层图像、CT图像及二者的融合图像,按CT解剖命名标准对肺灌注横断面、矢状面及冠状面图像上肺段进行划分.即右肺10段:上叶尖段、后段、前段,中叶外侧段、内侧段,下叶背段、内基底段、前基底段、外基底段、后基底段;左肺8段:上叶尖后段、前段、上舌段、下舌段,下叶背段、前内基底段、外基底段、后基底段,并总结3个层面肺段分布的特点.结果 确定了左右肺在横断面、矢状面及冠状面上的典型层面及各个肺段的主要分布特点:(1)横断面双肺由肺尖至肺底选取11个层面:胸锁关节层面及以上,主动脉弓上缘层面,主动脉弓层面,奇静脉弓层面或气管杈层面,右肺上叶支气管层面或左肺动脉层面,左肺上叶支气管层面或右肺动脉层面,中叶或舌叶支气管层面,底干支气管层面,下肺静脉层面,上下底段静脉层面,底段静脉层面;(2)双肺由内向外分别选取6个层面,左肺:左肺门层面,左主支气管杈层面,左肺动脉叶间部层面,心尖层面,心尖左侧第一层面,心尖左侧第二层面;右肺:右肺门层面,中间支气管杈层面,叶间动脉层面,叶间动脉分杈层面或右心房右侧第一层面,右心房右侧第二层面,右心房右侧第三层面向外;(3)冠状面双肺由前向后选取7个层面:胸锁关节层面,升主动脉层面,肺动脉杈层面,气管杈层面,中间支气管层面,底段总静脉层面,胸主动脉层面.结论 按该研究方法划分肺段,可为肺灌注断层图像中肺段的精确定位提供参考依据.

Accurate localization of pulmonary segments on pulmonary perfusion SPECT/CT imaging

Objective To investigate the methods for localization of the lung segments on three-dimentional (3D) pulmonary perfusion SPECT/CT imaging.Methods Twelve healthy adults were recruited into this study.Lung segments were defined based on the anatomical criteria of CT on transaxial, sagittal and coronal images, including apical, posterior, anterior segments in right upper lobe ( RUL), lateral, medial segments in right middle lobe ( RML), superior, anterior basal, lateral basal, posterior basal segments in right lower lobe (RLL); apical posterior, anterior, superior lingual, inferior lingual segments of left upper lobe ( LUL), superior, medioanterior basal, lateral basal, posterior basal segments of left lower lobe (LLL).Results (1) Eleven typical sections were selected on transaxial SPECT pulmonary perfusion imaging:sternoclavicular joint, supra-arch vessels, aortic arch, azygous arch, right upper lobar bronchus, left upper lobar bronchus, middle lobar or lingual bronchus, basal trunk of bronchus, lower lobar vein, superior and inferior basal vein and basal vein.(2) Twelve typical sections were defined on sagittal imaging:left hilum, bifurcation of left principal bronchus, septa of left pulmonary artery, cardiac apex, the first and second sections left to cardiac apex; right hilum, bifurcation of intermite bronchus, interlobar artery, bifurcation of interlobar artery, the second and third sections right to right atrium.(3) Seven typical sections were defined on coronal imaging:sternoclavicular joint, ascending aorta, bifurcation of pulmonary artery, bifurcation of trachea, intermite bronchus, basal vein and thoracic aorta.Conclusion The developed method was able to localize lung segments on pulmonary perfusion SPECT imaging.