儿童支气管镜的精准指导—支气管树的MSCT研究

Accurate guidance of bronchoscope for children-MSCT study of bronchial tree

目的 利用双源低剂量MSCT及后处理技术重组儿童支气管树,探讨儿童肺部支气管树的分型,为临床儿童支气管镜的精准指导提供价值。方法 回顾性分析336例儿童胸部MSCT图像,其中男性202例,女性134例,年龄3~12岁。应用西门子syngovia后处理技术重组支气管树。根据支气管的位置、走行方向、开口数量、分支共干、管径粗细等情况,对儿童支气管树进行分型。结果 336例儿童支气管树中,右肺上叶支气管树有四种类型,其中I型(B1,B2,B3)211例(62.8%),Ⅱ~IV型125例(37.2%)。右肺中叶支气管树固定为一种类型(B4,B5)。右肺下叶支气管树有五种类型,其中I型(B6,B7,B8,B9,B10) 233例(69.3%),Ⅱ~V型103例(30.7%)。左肺上叶支气管树有三种类型,其中I型(B1+2,B3,B4,B5) 266例(79.2%),Ⅱ和Ⅲ型70例(20.8%)。左肺下叶支气管树有四种类型,其中I型(B6,B7+8,B9+10) 277例(82.4%),Ⅱ~IV型59例(17.6%)。结论 MSCT可以准确显示儿童支气管树的解剖类型,可对儿童支气管镜检查的准确性提供重要指导依据。

Objective To investigate the types of pulmonary bronchial trees in children by double-source low-dose MSCT postprocessing technique,so as to provide clinical value for accurate guidance of children bronchoscopy. Methods 336 children’s chest MSCT images were retrospectively analyzed,including 202 males and 134 females,aged 3 ~ 12 years. The bronchial tree was reconstructed using siemens syngovia post processing technology. Children’s bronchial trees were classified according to the position,direction,number of openings,branches,diameter and thickness of the bronchus. Results Among the 336 children bronchial trees,there were four types of bronchial trees in the upper lobe of the right lung,among which 211 cases( 62. 8%)were type I( B1,B2,B3) and 125 cases( 37. 2%) were type Ⅱ-IV. The bronchial tree in the middle lobe of the right lung was fixed to one type( B4,B5). There were five types of bronchial trees in the lower lobe of right lung,of which 233( 69. 3%) were type I( B6,B7,B8,B9,B10) and 103( 30. 7%) were type Ⅱ ~ V. There were three types of bronchial trees in the upper lobe of the left lung,266 cases( 79. 2%) were type I( B1 + 2,B3,B4,B5),and 70 cases( 20. 8%) were type Ⅱ and Ⅲ. There were four types of bronchial trees in the lower lobe of the left lung,among which 277( 82. 4%) were type I( B6,B7 + 8,B9 +10) and 59( 17. 6%) were type Ⅱ ~ IV. Conclusion MSCT can accurately display the anatomical type of children’s bronchotree,which provides important guidance for the accuracy of children’s bronchoscopy.