多层螺旋CT增强扫描对支气管动脉的显示及其检测能力评价

Demonstration and detective ability evaluation for bronchial artery by using enhanced MSCT

目的 探讨多层螺旋CT增强扫描对支气管动脉的显示及其检测能力。方法 对10 1例研究对象行多层螺旋CT薄层增强扫描 ,检测支气管动脉。并将研究对象按疾病的有无和种类分成 5组 ,比较支气管动脉在各组病例中的显示率及内径差异性。结果 全部病例左、右支气管动脉分别共显示 83支和 79支。一侧同时显示 2支支气管动脉者左侧 13例 ,右侧 12例 ;1例左侧同时显示 3支。右支气管动脉与肋间动脉共干 35支 ,左侧只有 1支。左、右支气管动脉共干 2 3支。右侧支气管动脉行于右主支气管后方入肺 5 9支 ,内侧入肺 2 0支 ;左侧支气管动脉行于左主支气管后方入肺 2 3支 ,上方入肺 38支 ,内侧入肺 2 2支。肺癌组、支气管扩张组与对照组的显示率差异有显著意义 (P <0 .0 5 )。肺癌组、支气管扩张组与其他各组支气管动脉内径差异均具有显著意义 (P <0 .0 5 ) ,其他各组间差异无显著意义 (P >0 .0 5 )。结论 多层螺旋CT薄层增强扫描是一安全、无损伤、简便有效的支气管动脉影像显示方法 ;能真实显示肺癌和支气管扩张时支气管动脉起源、数目、形态和纵隔段走行 ,但尚不能清晰显示肺内段走行。

Objective To investigate the ability of enhanced MSCT in the demonstration and detection of bronchial arteries. Methods One hundred and one cases were examined with thin-slice enhanced MSCT. The data were grouped by the arterial origin and pathway entering into the lung, and the inner diameter of the bronchial artery was measured. Results In 101 cases altogether, MSCT scanning showed 79 right bronchial arteries and 83 left bronchial arteries. 2 bronchial arteries were detected on the left side in 13 cases and on the right side in 12 cases; 3 bronchial arteries were detected on the left side in 1 case. 35 right bronchial arteries co-originated with the intercostals arteries, and only 1 co-originated on the left side. Co-originated left and right side bronchial arteries were detected in 23 cases. 59 of the right bronchial arteries (74.7%) entered into the lung behind the right main bronchus, the other 20 (25.3%) entered through medial side. In 83 left side bronchial arteries, 23 arteries (27.7%) entered into the lung behind the left main bronchus, 38 (45.8%) entered through the supra side, and the other 22 (26.5%) through medial side of left bronchus. There was significant difference in the detective rate of bronchial artery among lung cancer group, bronchiectasis group, and normal group (P<0.05). There was obvious statistical difference (P<0.05) in the diameter of the bronchial artery between lung cancer group and other groups including normal, pulmonary embolism, pulmonary inflammation and bronchiectasis groups; the same as bronchiectasis group compared with normal, embolism and inflammation groups (P<0.05). There were no statistical differences (P>0.05) among inflammation, embolism, and normal groups. Conclusion MSCT thin-slice enhanced scanning is a safe, non-invasive, simple, and effective method in showing the bronchial artery, which can reveal the origin, number, shape, mediastinal pathway of the bronchial artery in the lung cancer and bronchiectasis accurately. But it can′t clearly show the pulmonary pathway.