胸部体检人群气管憩室变化的MSCT随访观察

目的:随访观察胸部体检人群气管憩室(TD)的MSCT表现变化,探讨其机制及意义。方法:搜集行胸部CT健康体检及MSCT随访复查的78例TD患者,对比观察憩室大小、分隔、憩室气管间隔(DTS)、憩室气管间气瘘管(AFDT)、气管指数(TI)及肺大泡改变。结果:TD位于气管右侧75例,左侧3例。随访复查显示TD体积增大者明显多于TD体积缩小者(χ^2值=4.51,P<0.05);首次检查和随访复查中,TD体积增大组与缩小组间的TD体积比较差异均有统计学意义(t值分别为4.35、5.72,P<0.05)。24例出现分隔,6例增粗,3例变细,11例变形。41例DTS宽度、长短或弯弧形态发生变化;首次检查和随访复查中,DTS宽度增大组与缩小组间的DTS宽度比较差异均有统计学意义(t值分别为4.23、4.87,P<0.05)。29例(37.18%)显示AFDT,复查消失9例,再现5例,走向变化17例。AFDT倾斜角随访变化量矢状面明显大于横轴面(t=6.35,P<0.05)。32例CTVE显示内口,最多者5个,随访消失3个,增多5个。44例TI比值增大患者中,31例TD增大,28例DTS变薄,32例AFDT形态走向发生变化,5例TD伴感染表现,6例新出现肺大泡。结论:TD形态和结构随访均可发生变化,关注TD变化有助于协同评估肺功能变化,对临床具有一定指导价值。

Follow-up observation of trachea diverticulum changes by MSCT in patients undergoing chest physical examination

Objective:To observe the changes of tracheal diverticulum(TD)by MSCT under chest physical examination in a follow-up study,and to explore the mechanism and implication of the changes.Methods:The MSCT features of 78 cases diagnosed with TD by health check-up were collected.Diverticulum size,separation,diverticulum trachea interval(DTS),aerated fistula between diverticulum and trachea(AFDT),trachea index(TI)and changes of pulmonary alveoli were analyzed.Results:Seventy-five TD were on the right side of trachea,3 on the left.There were more cases having increased TD volume during the follow-up than the cases with reduced TD volume(χ^2=4.51,P<0.05).There were significant differences of TD mean volume between volume increased group and reduced group at baseline and follow-up check-up(t=4.35,5.72,P<0.05).Among 78 TD cases,24 cases had space inside,6 had space enlargement,3 had thinner space,and 11 had deformation during the follow-up.The width,length or curved shape of DTS changed in 41 cases.There were significant differences of width of DTS between volume increased group and reduced group at baseline and follow-up check-up(t=4.23,4.87,P<0.05).AFTD was shown in 29 cases(37.18%).At follow-up check-up,AFTD disappeared in 9 cases,reappeared in 5 and direction changed in 17.During the follow-up,the change of slant angle in sagittal position of AFTD was significantly greater than it in cross position(t=6.35,P<0.05).The inlet of TD appeared in 32 cases with CTVE.At most there were 5 inlets for one case.Inlet disappeared in 3 cases and number of inlets increased in 5 cases at follow-up check.Among 44 cases with increased ratio of TI,33 cases had increased TD volume,28 had thinned width of DTS,32 had morpgologic trend changes of AFDT,5 had infection accompanied,and 6 had new onset pulmonary bullae.Conclusions:The morphological and structural changes of TD were observed during the follow-up.Paying attention to the changes of TD in check-up report is helpful to evaluate the changes of pulmonary function,and has a certain guiding significance for clinical practice.