CT仿真支气管镜的临床应用

目的：评价螺旋CT仿真支气管镜（CTVB）的临床应用价值。方法：对46例患者进行CTVB检查，并与轴位影像、MPR等后处理技术及纤维支气管镜（FOB）所见对照分析。结果：CTVB能够显示至亚段支气管腔内的结构及病变，酷似FOB所见，并可通过阻塞部位对远端支气管进行观察。25例中央型肺癌中，观察到34处管腔异常。5例气管癌、3例食管癌、甲状腺癌气管侵犯以及3例良性气管狭窄的准确地显示了狭窄的程度及范围。8例气管、支气管异物亦作出了正确诊断。结论：CTVB能够较真实地反映气管、支气管腔内的解剖结构及病变，可以部分代替FOB检查，不能显示粘膜改变及组织活检是其弱点，结合轴位图像及其他三维处理技术可提高诊断的准确性。

Clinical application of spiral CT virtual bronchscopy (with a review on 46 cases)

Objective To evaluate the clinical application of CT virtual bronchoscopy (CTVB). Methods CTVB was performed in 46 cases. The results and their processed axial and MPR images were compared with the findings of and fiberoptic bronchoscopy (FOB). Results Like FOB, CTVB clearly revealed the normal anatomy and varied lesions throughout the whole bronchial tree up to subsegmental bronchi, even including the areas beyond stenosis. Of the 25 cases with central type lung cancer, CTVB revealed 34 bronchial lesions, with a sensitivity of 94% and a postive predictive value of 94%. The degrees of stenosis in trachea were all accurately displayed, and the 8 cases of tracheobronchial foreign body were correctly diagnosed. Conclusion CTVB can be clinically used as a supplement of, and partly replace, FOB. However, it can neither detect mucosal abnormalities nor allow taking histologic samples. Combined with its axial and other 3D-reconstructed imagings, CTVB can increase its diagnostic accuracy.