64层螺旋CT后处理技术在右肺上叶支气管解剖中的应用

目的 应用64层螺旋CT支气管树和仿真内镜2种后处理方法显示右肺上叶段支气管,并对其分支形式进行分类.方法 对204例胸部CT扫描患者,重组右肺上叶支气管的支气管树和仿真支气管镜图像,分别应用2种图像对右肺上叶支气管分型,分析不同图像对不同分支类型支气管的显示效果;综合2种方法对右肺上叶支气管进行分型,统计2种方法联合应用的分型结果.结果 支气管树图像立体直观,可以准确显示典型的两两共干分支类型,当两两共干长度较短或类似3分支时,难以与3分支型区别;仿真支气管镜图像从内腔显示开口数目及"隆嵴"的形态,可以将共干长度较短的两两共干型与3分支型进行区分;综合应用支气管树及仿真支气管镜2种后处理方法对204例右肺上叶支气管分型显示,3分支型76例(37.3%),尖后共干型50例(24.5%),其他78例(38.2%).结论 支气管树与仿真内镜2种后处理方法综合应用,在对右肺上叶支气管分支形式分类的应用中具有独特的优势.

The application of post-processing of 64-slice spiral CT in the anatomy of the right upper bronchus

Objective To classify the segmental bronchial patterns of the right upper lobe by combining bronchial tree and CT virtual bronchoscopy(CTVE)post-processing techniques from 64-slice spiral CT.Methods Two hundred and four patients with routine thorax scans were enrolled.The segmental bronchi were demonstrated in terms of bronchial tree and CTVE.First,we checked how many patients can be classified with any one of the above post-processing approaches.Then,integrating the two methods,we classified the fight upper segmental bronchial patterns of the 204 patients.At last,the patterns of the right upper bronchus were analyzed.Results bronchial tree post-processing images were stereoscopic and intuitive.It could be used to identify common stem of bifurcation easily,however,it was hard to be used to differentiate short common stem of bifurcation from trifurcation.CTVE demonstrated segmental bronchi from inside of lumen,and can readily show the short common stem of bifurcation and trifurcation of bronchi.Combining two post-processing techniques,the segmental bronchial ramification of the right upper lobe was mainly classified in three types:trifurcation in 76 patients(37.3%),common stem of apical and posterior segmental bronchi in 50 patients(24.5%)and others in 78 patients(38.2%).Conclusion The combination of multiple post-processing of 64-slice CT posses great superiority to classify the pattern of the right upper lobe bronchi.