高对比剂注射速率下320排CT对支气管动脉的解剖学研究

Anatomical study on the bronchial artery with 320 row dynamic volume CT at high contrast injection rates

目的:探讨高对比剂注射速率下,采用320排CT分析咯血患者支气管动脉(BA)的正常解剖和异位起源情况。方法:对于173例在我院行BA-CT血管造影(CTA)检查的患者,通过观察其轴位、最大密度投影(MIP)及容积重建(VR)图来分析其分支类型、开口起源位置和异位起源。结果:本研究中,最常见的BA分支类型是II型(1R1L),占37.0%,在右侧BA中,有45.6%是以与肋间动脉共干形式存在;在左侧BA中,61.5%是单独起源的。本组占45.1%的患者含有至少1支异位BA。最常见的异位起源位置是降主动脉起始部,其次是主动脉弓。结论:尽管BA管径细小,解剖变异较大,但是在高对比剂注射速率下,320排CTA能很好地显示BA的正常解剖及异位起源,可为咯血临床治疗方案的制定提供有价值的信息。

Objective： To evaluate the normal anatomical features and ectopic origination of the bronchial artery in patients with hemoptysis using 320 row dynamic volume CT （DVCT） at high contrast injection rates. Methods： From June 2014 to Sptember 2015, 173 patients with hemoptysis underwent BA angiography was included. The site of origin and distribution of BAs was then analyzed with transverse, MIP, VR and 3D fusion images. Results： From the 173 studied population, the most frequent type of BAs was II type （1R1L）, which ac- count for 37.0%. On the right side, 45.6% of BAs originated from intercostal-bronchial trunk （IBT）; On the left side, 61.5% had BA with single origination. 45.1% of the studied population had at least one ectopic BAs. The most frequent sites of origin of ectopic BAs were the initial part of descending aorta, followed by the aortic arch. Conclusion： Even though the great variation and fine-calibrate of BAs, 320 DVCT at high contrast injection rate can preciously depicted the normal sites as well as ectopic origination of BAs, thus providing important anatomi- cal information prior to therapeutic decision making of bronchial arterial embolization （BAE）.