MSCT诊断气管支气管的价值

Tracheal Bronchus:MSCT Manifestations

目的:探讨多层螺旋CT对气管支气管的表现和诊断价值。方法:总结分析8例气管支气管的影像特点,6例行平扫检查,2例行增强扫描,4例行平片检查。CT后处理包括多平面重组(MPR)、最大密度投影(MIP)、容积再现(VR)、曲面重组(CURED)和三维重组(3D),重点对气管、主和段支气管的开口、分叉及行径采取追踪观察,并全面重建此种变异。结果:8例气管支气管中3例直接开口于气管,1例从隆突发出,4例起源于主支气管,并且5例为移位型气管支气管(移位的右上尖段支气管3例,移位的右肺上叶支气管2例),3例为额外型气管支气管(额外的右上叶尖段支气管),从CT冠状位重组图像中测得气管支气管与隆突平均间距约为1.52cm,与气管或主支气管的平均夹角约为62°,开口处的管腔径均值约为0.38cm。男5例,女3例,平均年龄37.6岁。仅有2例呼吸道症状与此直接有关。其中1例为气管支气管肺癌,1例合并右肺发育不良。同时,4例有胸片对照者中均无阳性表现。结论:MSCT扫描便捷、安全、准确,对其分型和观察明显优于其他检查手段,采用多平面重组是诊断气管支气管的最有效的方法。

Objective：To investigate the multislice CT （MSCT） findings of tracheal bronchus and its diagnostic value. Methods：Clinical data and imaging findings of 8 patients with tracheal bronchus were reviewed. Associated diseases include lung cancer （n= 1） and underdevelopment of right lung （n=1）. All 8 patients had MSCT scanning,in which 4 had conventional X-ray films. Postprocessing technologies used include MPR,MIP,VR,CPR （curved planar reformations） and 3D reconstruction images. Results：Three tracheal bronchi originated from the trachea, while 1 and 4 originated from the carina and main bronchi, respectively. Five cases are displaced type （3 were displaced right apical bronchi, 2 were displaced right-upperbronchi） ,3 cases are supernumerary right apical bronchi. The mean distance between the orifices of the tracheal bronchi and the carinae was 1.52cm, the mean angel between the lateral wall of the trachea or the main bronchi the tracheal bronchi originated from and the tracheal bronchi is 62°, and the mean diameter of orifices of the tracheal bronchi is 0. 38cm. X-ray plain film of 4 cases had no positive finding about tracheal bronchus. Conclusion： MSCT combined with postprocessing technologies,especially coronal MPR,is superior to radiography in the diagnosis and depiction of tracheal bronchus.