原发性气管肿瘤的轴位CT和三维后处理图像表现

CT and three-dimensional post-processing manifestation of primary tracheal tumors

目的:探讨原发性气管肿瘤的CT表现及三维重建技术在其外科手术的应用价值,提高对该病的CT诊断和治疗水平。方法:回顾性分析7例经手术病理证实的原发性气管肿瘤的CT表现,并对其图像进行VR、MPR和CTVE后处理。结果:①7例肿瘤均位于主支气管,表现为突入气管腔的类圆形、椭圆形肿块2例,不规则分叶状肿块3例;管壁局部不规则增厚2例。增强扫描肿瘤不同程度强化。4例浸润邻近组织;3例肺门或纵隔淋巴结转移。1例出现阻塞性肺不张。②MPR矢状位图像可沿气管长轴观察肿块与气管壁的关系,判断肿块距气管隆突的距离。VR可显示肿瘤基底的范围和光滑度等情况;可从三维角度观察肿块与气管壁连接的形态。CTVE可以从不同角度显示肿瘤的大小、形态、肿瘤表面情况及气管狭窄程度。结论:CT检查对原发性气管肿瘤的检出和术前诊断具有重要价值,三维重建技术可以为手术治疗提供重要依据。

Objective： To study the CT manifestations of primary tracheal tumor（PTT） and to explore the clinical value of postprocessing. Methods： CT features of 7 patients with PTT proved pathologically were retrospectively analyzed. VR, MPR and CTVE was reformed on the workstation. Results： （1）All of the 7 tumors located in the main bronchi, 2 tumors were ovoid or ellipsoid mass protruded into the lumen, 3 tumors were irregularly lohulated mass, and the bronchial wall irregularly thickened in 2 cases. Tumors were enhanced in post-contrast scanning at different level, with 4 cases of adjacent structure infiltration, 3 eases of lung hilar or mediastinal lymph nodes metastasis, 1 case of lung atelectasis. （2）The relationship between tumor and the bronchial wall could be observed on MPR sagittal reformatted images along the long axis of trachea, so that the distance between the mass and carina could be measured. VR image could show the range and smoothness of the tumor base, and the connection between the mass and tracheal wall could be observed in different angle. CTVE could show the size, shape, and the surface of tumor, and the tracheal narrowing as well. Conclusion： There is great value in diagnosing PTT by CT. The postprocessing is helpful for the operation.