CT三维重建在肺结节肺段切除中的应用价值

The value of CT three-dimensional reconstruction of pulmonary nodule in guiding the thoracoscopic pulmonary segmental resection

目的探讨肺结节CT三维重建技术在胸腔镜肺段切除术中的应用价值。方法选取在我院拟行胸腔镜肺段切除术的45例肺结节患者,术前行CT增强扫描并三维重建,重建肺结节、胸廓、透明肺、肺动脉、肺静脉及支气管树的三维图像并进行图像融合,同时对图像质量进行评分。通过多方位、多角度观察分析肺结节与周围组织结构的空间关系,为肺结节胸腔镜肺段切除提供参考。结果45例患者三维重建图像均能满足临床要求,肺结节与周围组织空间结构关系显示良好。其中41例三维重建图像评价3分(91%),3例图像评价2分(7%),1例图像评价1分(2%),呼吸配合和扫描时相是影响图像质量的主要因素;45例患者均在CT三维重建指导下成功行外科胸腔镜肺段切除术,术后无严重并发症。结论肺结节CT三维重建图像可较好的显示肺结节与周围组织的空间关系,在胸腔镜肺段切除术中有较高的应用价值。

Objective To assess the value of CT three-dimensional reconstruction of pulmonary nodule in guiding the thoracoscopic-pulmonary segmental resection.Methods From January 2021-March 2022,45 patients scheduled for thoracoscopic pulmonary segmental resection were performed enhanced CT scan before operation.The three-dimensional reconstruction and fusion process of pulmonary nodules,vessels,bronchus were carried out.Spatial relationship between pulmonary nodules and surwere rounding anatomical tissues were observed from multiple angles.The quality of images was scored.Results All the 45 patients’images can meet surgical requirements.41 cases were scored 3(91%),3 cases scored 2(7%)and 1 case scored 1(2%).Breath control and appropriate sanning time were the main factors of image quality.45 cases were performed thoracoscopic pulmonary segmental resection successfully with guidance of the three-dimensional reconstruction.There was no severe complications after surgery.Conclusion CT three-dimensional reconstruction of pulmonary nodule can demonstrate the spatial relationship between pulmonary nodules and surrounding anatomical tissues.It can be widely used in guiding the the thoracoscopic pulmonary segmental resection.