三维CT支气管血管重建技术在胸腔镜精准肺段切除术中的应用

Application of three-dimensional CT bronchovascular reconstruction technique in thoracoscopic accurate pulmonary segmentectomy

人肺部的解剖结构复杂,其中支气管、动脉、静脉及动静脉分支的走行变化多样.肺癌是一种发病率较高的呼吸系统恶性肿瘤.与对早期肺癌患者进行传统的肺叶切除术相比,对其进行胸腔镜肺段切除术的难度更大,对手术精准度的要求更高.三维CT支气管血管重建(threedimensional-computed tomography bronchography and angiography,3D-CTBA)技术是一种先进的影像学技术.对早期肺癌患者进行胸腔镜精准肺段切除术前,对其病灶图像实施三维CT支气管血管重建,能清晰地显示其肺部的三维解剖结构及肺段支气管、动脉、静脉的走行及变异情况,明确其病灶的位置及归属的肺段,规划手术的安全切缘及手术路径,实现术前的规划、导航、模拟、推演及术中的对照解剖,进而可显著提高手术的精准度和安全性.本文主要是对三维CT支气管血管重建技术在胸腔镜精准肺段切除术中应用的情况及相关的研究进展进行介绍.

the anatomical structure of human lung is complex,in which the bronchi,arteries,veins and arteriovenous branches vary.Lung cancer is a high incidence of respiratory malignancy.Compared with traditional lobectomy for patients with early lung cancer,thoracoscopic pulmonary segmentectomy is more difficult and requires higher surgical accuracy.Threedimensional-computed tomography bronchography and angiography(3d-ctba)is an advanced imaging technology.For early lung cancer patients for precision thoracoscope lung segment resection before,for the lesions image three dimensional CT bronchial vascular remodeling,can clearly display the three-dimensional anatomic structure of the lungs and pulmonary segment bronchi,arteries,veins and the variation of the situation,the specific location of the lesions and the attribution of lung segment,cutting edge and the safety of the surgery path planning operation,preoperative planning,navigation,simulations,deduction and comparison of anatomy,thus can significantly increase the accuracy of the operation and safety.This paper mainly introduces the application of three-dimensional CT bronchovascular reconstruction technology in thoracoscopic accurate pulmonary segmentectomy and the related research progress.