气管支气管内结核的多层螺旋CT及其三维重组表现

目的了解气管支气管内膜结核的多层螺旋CT及其三维重组图像表现,评价多层螺旋CT诊断支气管内膜结核的价值。方法18例经纤支镜及手术证实的气管支气管内膜结核患者行多层螺旋CT扫描,将容积扫描数据预处理后传至工作站,分别行MPR(CPR)、MIP、VR、SSD及CTVE成像,分析其影像学表现,重点观察支气管管腔和管壁的形态学改变。结果MSCT轴位及其三维重组图像均明确显示支气管管腔变窄,管腔表面不光滑和腔内结节状突起,管腔扭曲变形;管壁增厚,密度增高,僵直和钙化。轴位图像还可显示肺内伴随表现。结论气管支气管内膜结核MSCT及其三维重组图像有一系列的表现征象,MSCT及其三维重组图像对病变的定位,受累范围的测量等有很大帮助,是临床上一种无创性评价气管支气管病变的有效方法,可用于气管支气管内膜结核患者的介入治疗前的定位和治疗后随访。

Features of Endotracheal and Endobronchial Tuberculosis in MSCT and its 3D Images

Objective:To analyse the MSCT and its 3D images manifestations of endotracheal and endobronchial tuberculosis.Methods:Volume scanning with Multi-slice spiral CT was performed in 18 patients with endotracheal and endobronchial tuberculosis proved by surgery and fibrous endoscopy examinations.The preprocessed image data were sent to the workstation and reconstructed with multiplanar reconstruction (MPR),minimum intensity projection (MIP ),volume rendering (VR),shaded-surface display (SSD) and CT virtual endoscopy (CTVE) respectively.The imaging findings,especially the morphologic changes of the lumen and wall of trachea and bronchi were analyzed.Results:The MSCT and its 3D images of these patients showed the lumen and wall changes.The lumen changes included narrowing,coarse surface and intraluminal nodular protruding.The wall changes included:the thickening of the wall,increased density,rigidity of the wall and calcified foci.The associated characteristics of lung were revealed in axial images.Conclusion:Endotracheal and endobronchial tuberculosis has a series of features in MSCT and its 3D images;MSCT and its 3D images can be helpful to orient the focus and measure the length of narrowed airway,it is a noninvasive and effective method for evaluating endotracheal and endobronchial tuberculosis.