肺门区横断面CT与解剖对照研究

目的：了解正常肺门断层解剖及CT表现。方法：结合20例胸部边疆横断层标本，研究56例肺门区的CT表现。结果：右侧：右上肺静脉法支位于尖段支气管和动脉与上腔静脉之间，肺门外侧为右上肺静脉后支，后方为后段支气管和同名动脉分支。左侧：左肺静脉尖后支位于尖后段支气管和动脉的前方，或组成肺门外侧。以上观察与CT表现一致。85.7%(48例）左肺静脉尖后支位于尖后段支气管和动脉的前方；14.3%(8例）位于肺门外侧。85%（17例）右上肺静脉后支则位于前、后段支气管二者的夹角内，15%（3例）在此层面远离肺门；CT上，92.9%（52例）右上肺静脉后支则位于前、后段支气管的夹角内，7.1%（4例）在此层面远离肺门。结论：右肺门上、中区的形态与上肺静脉尖支和后支的位置和汇入上肺静脉方式有关。左肺门上区的形态与肺动脉和上肺静脉之间的关系有关；左肺门中区的形态则取决于左肺动脉舌支的发支情况。双肺门下区的形态取决于下叶肺动脉的分支形式。

CT of the pulmonary hilain transverse sections: correlated with sectional anatomy

Objective To study sectional anatomy and CT features of pulmonary hila.Methods: CT features of pulmonary hila in 56 patients were contrasted with the successive sectional anatomy features of breast in 20 Chinese adult cadaver specimens.Results: In the right, the apical branch of the right superior pulmonary veins situated among the apical bronchia,arteries and the superior vena cava.The posterior branch of the right superior pulmonary veins situated in the lateral side of the right upper hila,and the posterior branch of bronchia and the same name branch of the right pulmonary areries situated in the posterior parts of the right upper hila.In the left, the apical branch of the left pulmonary veins was in front of the apical and posterior branches of bronchia and artetries,and consisted of the lateral side of left hila.The features were same as in CT,the apical and posterior branch of bronchia and arteries were in front of the upper part of the left hila; 14.3% (8/56)were in the lateral side.The right superior pulmonary veins in 17 (85%) specimens were in the angles of the anterior and posterior branches of bronchia,3(15%) specimens were far from here.The right superior pulmonary veins were in the angles of the anterior and posterior branches of bronchia in 92.9%(52/56), and 7.1%(4/56) were far from here in CT. Conclusions: The appearance of upper and middle parts of right hila in related to variarions of origins of the apical branch and posterior branch of superior pulmonary vein, and the appearance of upper part of left hila is related to variations of both pulmonary artery and left superior pulmonary vein; The different converging pattern of the lingular branch of left pulmonary artery is related to the middle part of left hila.The lower parts of the both pulmonary hila are related to the branch pattern of the pulmonary arteries in lower lobes.