多层螺旋CT及后处理重建在气管主支气管肿瘤诊断中的应用

目的探讨多层螺旋CT及后处理重建技术对气管主支气管肿瘤的临床应用价值。方法回顾性分析经手术病理证实的原发气管主支气管肿瘤24例的多层螺旋CT检查，全部源像在AW后处理工作站上进行包括多平面重建（MPR）、肺透明化重建（VR）及仿真内窥镜（CTVE）重建，分别得到MPR，VR，CTVE图像。结果本组24例原发气管支气管肿瘤中恶性肘，瘤20例，良性4例，病变位于气管13例，左主支气管4例，右主支气管5例，隆突上方2例；宽基底16例，窄基底8例：不规则生长14例，环状生长2例，偏心8例；12例外侵与邻近结构粘连，4例轻度向外生长，但未累及周同结构，8例在管壁上并向腔内突出；1例脂肪瘤为低密度影．不强化，良性肿瘤密度较均匀，中度强化，恶性肿瘤密度欠均匀，强化亦不均匀；气管肿瘤姑息治疗支架置入术后疗效观察9例。结论多层螺旋CT及其后处理重建技术可以对原发气管、主支气管肿瘤进行定位、定性诊断有利于良恶性肿瘤的鉴别诊断，可指导临床治疗及支架置入术后疗效观察，是一种准确且无创性诊断技术。

Applications of MSCT with postprocessing techniques in the diagnosis of tracheobranchial tumors

Objective To discuss the clinical applications of muhislice spiral computed tomography （MSCT）with postprocessing techniques in the diagnosis of tracheobronchial tumors （TBT）.Methods Twenty-four patients with surgically and pathologically proved TBT underwent MSCT examinations.The all source images were transferred into workstation and reconstntcted by using postprocessing techniques which comprised MPR,VR and CTVE.The CT findings of TBTs in all patients were analyzed retrospectively.Results Among 24 patients with primary TBT,malignant and benign tumors were found in 20 and 4 eases,respectively.The sites of TBTs included trachea （n= 13）,left main bronchi （n=4）,right main bronchi（n=5）,and upper part of tracheal protuberance （n=2）.The TBTs appeared as broad base （n= 16）, narrow base （n=8）,irregular growth （n=14）eircular growth （n=2）,and eecentric growth （n=8）; peritumoral invasion and adhering to neighbour structures （n=12）,slightly growing-out but no infiltrating into surrouding structures （n=4）,and involvement of vessel walls associated with intraluminal bulge （n=8）.A case of lipmna appeared hypodense and non-enhancement.Other 3 cases of benign tumor were homogeneous density and middling enhancement,while all malignant tumors appeared as non-homogeneous density and non-homogeneous enhancement.Nine patients with tracheal tumors underwent implantations of stent and follow up observations of therapeutic effects after operation.Conclusion As non-invasive imaging technique,MSCT with postprocessing techniques can accurately perform the localized and qualitative diagnosis of TBT and can assess the therapeutic effects of stent implantation.