螺旋CT及三维重建技术在中央型肺癌诊断中的应用价值

目的 探讨螺旋CT及三维重建技术对中央型肺癌诊断的临床应用价值。方法 中央型肺癌（n=23)患者行螺旋CT薄层扫描（层厚2mm-3mm)且行三维重建，三维重建方法包括表面遮盖成像（SSD）、最小密度投影（MinIP)及多平面重建（MPR）。结果 螺旋CT薄层图象及MPR重建均可准确显示中央型肺癌病灶发生部位，气管支气管阻塞气管树SSD及MinIP成像可整体直观显示其阻塞和狭窄范围及程度，SSD及MinIP图像较粗糙，显示病灶解剖细节差，对显示早期小病灶及小支气管改变有一定限制。结论 螺旋CT薄层横断面及MPR图像是诊断中央型肺癌准确有效方法，SSD及MinIP图像较直观，可弥补其横断面图像的不足，但不能显示病灶的解剖细节。

Clinical application of 2D,3D spiral CT in diagnosing central pulmonary carcinoma

To assess the clinical value of 2D, 3D spiral CT in diagnosing central type pulmonary carcinoma. Methods central pulmomary carcinomas (n =23) confirmed by pathology were examined by spiral CT (2mm-3mm slice thickness), SSD, MinIP and MPR reconstruction were used as three-dimensional models. Results 2D spiral CT and MPR could display all lesions, extent of bronchial stenosis and occlusions, obstructive atelectasis and pneumonia, mediastinal lymphaden enlargement and the relationship of lesions to adjacent mediastinal structures were also well demonstrated. SSD could reveal the whole shape of the lesions. SSD and MinIP of tracheobronchial tree could show the stenosis or occlusion extent of trachea or bronchus as anatomy. To reveal small bronchus, small lesions and early changes caused by central pulmonary carcinoma, SSD and MinIP had limited value. Conclusion 2D spiral CT and MPR were effective methods in the diagnosis of central pulmonary carcinoma. SSD and MinIP can make up the disadvantages of 2D spiral CT.