多层螺旋CT三维血管成像对肺隔离症诊断的价值  

Multidetector CT angiography in pulmonary sequestration

作　　者：甘新莲[1] 陈唯唯[1] 张自力[1] 宋少辉[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,湖北武汉430030

出　　处：《医学影像学杂志》2008年第7期730-732,共3页Journal of Medical Imaging

摘　　要：目的:探讨多层螺旋CT三维血管成像在肺隔离症诊断中的应用价值。方法:收集经手术及病理证实的9例肺隔离症患者的资料进行回顾性分析。所有检查采用GE lightspeed 16层CT扫描机,先行CT平扫,再行双期增强扫描,将图像传输至工作站,进行MPR、MIP、SSD及VR重建。结果:9例肺隔离症均位于下叶后基底段,其中8例位于左下肺,1例位于右下肺。异常供血动脉7例来自于胸降主动脉,2例来自于腹主动脉上段。CT平扫主要表现为肺内囊肿、结节或肿块,局部可伴肺气肿征。增强扫描病变区血管影增多、增粗,呈条状或结节状血管强化影。CT血管成像显示病变由异常体动脉供血。采用MPR和MIP可显示供血动脉整体形态及肺实质的病灶。SSD及VR能显示供血动脉的起源与行程及引流静脉。结论:多层螺旋CT增强及三维重建是诊断肺隔离症最理想非创性检查方法。Objective：To study the role of multidetector CT angiography in the diagnosis of pulmonary sequestration.Methods：Nine patients confirmed by surgery and pathology were analyzed retrospectively in our study.All examinations were performed on a 16-detector helical CT（lightspeed 16,GE Medical System）.After noncontrast CT scan,all patients underwent dual phases contrast CT and 3D CT angiography.Then,the images were transferred to workstation to generate MPR,MIP,SSD and VR images.Results：CT angiography showed that all the pulmonary sequestration located in the posterior basal segment（eight on the left and one on the right）.Aberrant systemic arterial supply was demonstrated in all cases,which arose from the descending thoracic aorta（n=7） and from superior segment of abdominal aorta（n=2）. On noncontrast CT images,pulmonary sequestration showed cyst in the pulmonary parenchyma,nodule or mass,and emphysema around the lesion.On contrast CT images,increased and thickened vessels were found in the lesion,which exhibited as cordlike or nodular enhancement.CT angiography showed aberrant systemic arterial supply.The feeding artery and lesion in the pulmonary parenchyma could be demonstrated simultaneously by MPR and MIP images.SSD and VR images could reveal the origin and path of the aberrant feeding artery and venous drainage.Conclusion：The contrast CT scan and 3D CT angiography on the multi-detector helical CT are the best noninvasive diagnostic methods for the pulmonary sequestration.

关 键 词：支气管肺隔离症 体层摄影术 X线计算机 血管成像 

分 类 号：R562.2[医药卫生—呼吸系统] R814.42[医药卫生—内科学]