64层螺旋CT多平面重组显示肺叶间裂变异的价值

Visualization of variations in the pulmonary fissures on multi-planar recontruction images of 64-slice spiral CT

目的观察肺叶间裂及变异在64层螺旋CT多平面重组（MPR）的显示及分布。方法64层螺旋CT以0．6mm层厚采样扫描1235例胸部病变患者，使用MPR技术显示肺叶间裂及变异（包括附属裂）。结果1235例患者中肺叶间裂无变异者占80．08％（989例），变异者占19、92％（246例）。变异肺中，双侧变异20．33％（50例）；单侧变异79．67％（196例），其中右肺变异63．01％（155例），左肺16．66％（41例）。右肺既无斜裂亦无水平裂1．22％（3例），左肺无斜裂（6．91％，17例）比右肺多（3．65％，9例）。左肺斜裂不全（8．53％，21例）比右肺多（4．06％，10例）。246例中右肺无水平裂27．24％（67例），水平裂不全9．76％（24例）。肺附属裂83．33％（205例），右肺（53．66％，132例）比左肺多（29．67％，73例），右下叶段（40．65％，100例）明显高于左下叶段（7．72％，19例），舌裂15．85％（39例）。斜裂和水平裂形态和位置改变41．06％（101例），右侧（35．37％，87例）高于左侧（5．69％，14例）。结论64层螺旋CTMPR完全能显示肺叶间裂、肺叶间裂变异和附属裂，而且能区别病变和小血管。

Objective To observe the variations and distribution of the pulmonary fissures of normal subjects in China on multi-planar recontruction （MPR） images of 64- slice helical CT. Methods A total of 1235 subjects underwent 64- slice helical CT scan with a slice thickness of 0. 6 mm. The MPR images were observed to find normal interlobar fissures and the variations including the accessory fissures occurred in lobar or segmental lungs. Results Of the all cases, no variation was seen in 80. 08% （989/1235）, and pulmonary fissure variations occurred in the remaining 19.92% （246/1235） . Among pulmonary fissure variations, 20. 33% （50 cases）occurred bilaterally, with the other 79. 67% （ 196 cases） unilaterally. Of the unilateral pulmonary fissure variations, 63.01% （155 cases） was seen in right lungs, and 16.66% （41 cases）was found in left lungs. There was neither oblique nor horizontal fissure in 1.22% （3 cases） of right lungs. Absence of oblique fissure happened more frequently in left lungs （6. 91%, 17 cases） than right lungs（3.65%, 9 cases）. Incomplete oblique fissure happened more frequently in left lungs（8. 53%, 21 cases） than in right lungs（ 4. 06% ,10 cases）. Totally, absence of the horizontal fissures were found in 27.24% （67 cases） of the subjects, and incomplete horizontal fissures were found in 9.76% （24 cases）. Accessory fissure were found in 83.33% （205 cases） of the subjects, and they happened more frequently in right lungs than in left lungs（53.66%, 132 cases on the right, while 29. 67%, 73 cases on the left）. Accessory fissures on right lower lobe and segments happened much more than on the left （40. 65%, 100 cases on the right, while 7. 72% , 19 cases on the left）. Lingular fissures in the lungs were found in 15.85% （39 cases）. The changes in shape and location of the oblique and horizontal fissures were found in 41.06% （ 101 cases） , and happened more frequently in right lungs than left lungs （35.37% ,87 cases on the right, 5.69%, 14 cases on the left）. Conclusions Sixty-four-slice helical CT with MPR can clearly display pulmonary fissures and their variations, and it can distinguished small lesions from small vessels.