CT仿真支气管内窥镜的临床应用研究

CT virtual bronchoscopy:clinical application

目的评价ＣＴ仿真支气管内窥镜的临床应用价值。方法４５例患者均有纤维支气管镜对照并经病理证实。使用内窥镜软件将图像数据重建为三维支气管树图像，通过鼠标操作进入支气管腔内检查。结果ＣＴ仿真支气管内窥镜检查３２例肺癌患者，发现支气管狭窄３０处、闭塞１７处，淋巴结外压性狭窄５处。其余为炎症３例，结核病１例，出血１例，肺癌术后肉芽肿１例，正常７例。漏诊粘膜下肿瘤转移或浸润５例，充血肿胀、出血４例。结论ＣＴ仿真支气管内窥镜是一种安全无创的诊断方法，可部分替代纤维支气管镜检查。

Objective To evaluate clinical applications of CT virtual bronchoscopy. Methods 45 patients were examined with CT bronchoscopy. All were proved with fiberoptic bronchoscopy and pathology. The cross sectional images were reconstructed to 3D tracheobronchial tree image using endoscopy software and navigate or “fly through” from trachea to subsegmental bronchus simulating fiberoptic bronchoscopy. Results CT bronchoscopy could reveal stenosis( n =30),bronchial occlusions( n =17) and extraluminal compression by lymphadenopathy( n =5) in 32 patients with cancer of lung. Other findings inflammation( n =3), tuberculosis ( n =1), hemorrhage ( n =1), granuloma after operation for pulmonary carcinoma( n =1), and normal( n =7). The missed diagnosis with CT bronchoscopy included mucosal metastasis or infiltration( n =5), hyperemia and mucosal swelling( n =3), and hemorrhagic focus( n =1). Conclusions CT virtual bronchoscopy provides an safe and noninvasive diagnostic method, with may partly replace fiberoptic bronchoscopy.