MSCT三维重建技术在支气管内膜结核的诊断应用

Clinical Application of MSCT Three-dimen-sional Reconstruction Technique in Endo-bronchial Tuberculosis

目的探讨MSCT三维重建技术在气管支气管内膜结核的临床应用价值。方法回顾性分析48例经支气管纤维镜及病理确诊为气管支气管内膜结核,行多层螺旋CT扫描,所有数据发送至重建工作站进行三维重建。结果 48例病例中,病变多为单侧发病,44例,双侧发病为4例,35例为多支气管发病,其中累及气管4例,右主支气管6例,右中间段支气管3例,右上叶支气管15例,右下叶支气管6例,左主支气管19例,左上叶支气管15例,左舌叶支气管8例,左下叶支气管7例,累及支气管均显示管壁增厚,管壁钙化者7例,管壁凹凸不平,管腔均有不同程度狭窄,病变范围均长于2cm;伴肺叶或肺段不张33例,其中不张或实变区可见钙化25例,支气管扩张33例;胸膜增厚各20例,肺门及纵隔淋巴结钙化25例。结论 MSCT三维重建技术在支气管内膜结核病变中可立体、多方位观察气管及支气管受累范围,了解管壁、管腔情况,为临床诊断提供更多的可靠信息。

Objective To explore the clinical value of MSCT three-dimensional reconstruc- tion technique in Endobronchial tuberculosis. Methods Retrospective analysis of forty- eight cases diagnosed as Endobronchial tuberculosis by pathology alter bronchial fiber- scope biopsy. All patients with CT scan, the data sent to three-dimensional reconstruction workstation. Results In the 48 cases ,there were 44 cases with unilateral disease. 4 cases with bilateral incidence, 35 cases with multiple bronchial disease,included 4 cases tracheal, 6 cases right principal bronchus, 3 cases right middle segmental bronchus, 15 cases the right upper lobe bronchus, 6 cases the right lower lobe bronchus, 19 cases Left principal bronchus. 15 cases the left upper lobe bronchus,8 cases the left lingual lobe bronchus,7 cases left lower lobe bronchus involvement. All of the involved bronchial showed pipe wall thickness, 7 cases showed tube wall calcification. The tube wall is uneven, with different degree of stenosis in lumen, all lesions are longer than 2cm. 33 cases With lobar or segmental atelectasis, 25 cases with Calcification,33 cases with Bronchiectasis.20 cases showed Pleural thickening, 25 cases showed hilar and mediastinal lymph node calcification. Conclusion MSCT three- dimensional reconstruction technique can intuitive and multi-dimensional observation of the wall and the lumen, can provide more reliable information for the clinical diagnosis of Endobronchial tuberculosis.