多层螺旋CT三维肺血管重建技术及其在中心型肺癌的初步应用

Preliminary application of three-dimensional reconstruction of multi-slice spiral CT in pulmonary vessels in central type of lung cancer

目的:探讨多层螺旋CT(MSCT)三维肺血管成像技术及其在中心型肺癌病例中的应用价值。方法:对21例中心型肺癌的病人行MSCT增强造影检查,采用实时螺旋扫描,在独立工作站上进行三维肺血管重建,使用不同的旋转轴观察肿瘤与肺血管的关系。结果:全部病例的三维肺血管图像都能准确、直观地观察到肺血管与肿瘤的空间毗邻关系。在中心型肺癌其邻近肺动脉的改变呈现3种类型:A型,手握球型;B型,枯树枝型;C型,残根型。不同类型有不同的病理学特点。不同方法的三维重建对肺血管的显示能力有明显差异。结论:MSCT三维肺血管图像能够准确、直观地显示肺血管的立体解剖特点以及与肺癌的空间毗邻关系,为制定手术治疗方案提供了客观依据,是CT横断面图像的重要补充。

Objective:To discuss three-dimensional reconstructive techniques of multi-slice spiral CT(MSCT)in pulmonary vessels and its application value in central type of lung cancer.Methods:MSCT angiography was done in21patients with central type of lung cancer,using real time helical scanning.Three-dimensional images of pulmonary vessels were performed at the console workstation.We viewed relations between pulmonary vessels and tumor using different rotation.Re sults:Three-di-mensional images of all patients could be accurately and directly revealed the relation between tumor and vessels.Alteration of pulmonary arteries adjacent to the cancer lesion appeared as three types:type A,hand-grasping-ball type;type B,withered-branch type;type C,truncated root.Different types have different characteristics of pathology.There are significant differences of visualization capabilities of pulmonary vessels among different 3D techniques.Conclusion:①With the utilization of multiple methods,3D reconstruction can play an important role in the vivid recognition of the anatomical features of pulmonary vessels and space relations between tumor and vessels.②Providing information for operation and future treatment.③It is an important complement to the axial CT images.