支气管动脉的CT解剖分型

Anatomical Classification of Bronchial Artery on CT Angiography

目的探讨基于64排螺旋CT血管成像(CTA)的支气管动脉(BA)解剖分型及其临床应用价值。方法利用136例患者的动脉期CT增强扫描数据进行容积再现、最大密度投影、多平面重组,获得BA三维重组图像并将其分为6型,同时了解BA起始端的三维定位信息。结果 BA共计显示358支,其中右BA 188支,左BA 170支。R1L1型者占50.0%(68/136),R2L1型者占24.3%(33/136)。在BA的解剖分型中,右BA常见于Ⅰ型(77/188,41.0%);左BA多见于Ⅳ型(110/170,64.7%)。100%(77/77)Ⅰ型,59.3%(32/54)Ⅱ型和100%(9/9)Ⅴ型BA起源于胸主动脉右壁,83.3%(40/48)Ⅲ型和56.4%(62/110)Ⅳ型BA起源于胸主动脉前壁。BA胸主动脉起始端位于气管隆突上下2 cm范围内者占85.6%(255/298)。结论 BA的CT解剖分型结合其胸主动脉起始端的三维定位信息,对介入放射医师快速准确地实施BA介入手术具有重要指导意义。

Objective To evaluate anatomical classification of bronchial artery （BA） on 64 detector CT angiography （CTA） images and its clinical value. Methods 136 patients underwent CTA. The anatomical classification of BA were e-valuated using volume rendering （ VR）, muhiplanar reconsttuction （MPR） and maximum intensity projection （MIP）. Spa-tial localizing data of BA arise from thoracic aorta was measured simultaneously. Results Altogether 358 Bas, including 188 right BAs and 170 left Bas were identified. R1L1 and R2L1 BA type accounted for 50.0% （68/136） and 24.3% （33/136） respectively. The right BAs were commonly found in type Ⅰ （77/188, 41.0% ）, while the left BAs were most-ly in type Ⅳ （ 110/170, 64.7% ）. BAs originated from the right wall of thoracic aorta were found in type Ⅰ , type Ⅱ and type V with frequencies of 100% （77/77） , 59.3 % （ 32/54 ） and 100% （9/9）, respectively. BAs originated from the anterior wall of thoracic aorta were found in type Ⅲ and type Ⅳ with 83.3% （40/48） and 56.4% （62/110）. There were 85.6% （255/298） BAs originating at thoracic aorta within range of ± 2 cm from tracheal bifurcation. Conclusion The CTA classification of BAs combines with localizing data play an important role in BA interventional operation.