多层螺旋CT在支气管内膜结核诊断及治疗评价中的应用价值

目的探讨多层螺旋CT(MSCT)在支气管内膜结核诊断及治疗评价中的应用价值。方法回顾性分析32例经纤维支气管镜证实的支气管内膜结核的CT轴位图像表现,并对在工作站获取的薄层图像分别进行多平面重建(MPR),CT仿真内窥镜(CTVE),表面遮盖(SSD)3种方法后重建。结果共有49处气管受累,主支气管2例,右主支气管4例,左主支气管3例,右肺上叶支气管15例,左肺上叶支气管12例,右中叶支气管4例,右肺下叶支气管5例,左肺下叶支气管4例。CT表现为支气管阻塞12例,支气管腔狭窄18例,支气管壁增厚13例,支气管壁钙化6例,伴肺门及纵隔淋巴结钙化27例。结论多层螺旋CT多种重建方法的结合应用,可以明确显示病变的发生部位及支气管腔狭窄或阻塞,有利于支气管内膜结核的诊断及治疗评价。

Applied Value of Multi-slice Spiral CT in Diagnosis and Therapeutic Evaluation of Endobronchial Tuberculosis

Objective To study the applied value of multi-slice spiral CT(MSCT) in the diagnosis and therapeutic evaluation of endobronchial tuberculosis.Methods CT fingings of endobronchial tuberculosis on axial images in 32 cases proved fiberoptic bronchoscopy and pathologically were analyzed retrospectively,then the data was transmitted to the workstation and reconstructed with multiplanar reconstruction(MPR),CT virtual endoscope(CTVE) and surface shaded display(SSD) respectively.Results Totally 49 bronchi were involved including trachea in 2,right main bronchus in 4,left main bronchus in 3,right superior lobar bronchus in 15,left superior lobar bronchus in 12,right middle lobar branches in 4,right inferior lobar bronchus in 5 and left inferior lobar in 4.Main CT features were as follows:obstruction of bronchial lumen in 12 cases,stricture of bronchial lumen in 18 cases,bronchial wall thickening in 13 cases,calcification of bronchial wall in 6 cases,calcification of hilum of lung or mediastinal lymph node in 27 cases.Conclusion In the combination with multiple reconstruction method of MSCT can detecte the localization of endobronchial tuberculosis,bronchial lumen stricture and obstruction,it is helpful in diagnosis and therapeutic evaluation of this disease.