CTA对慢性阻塞性肺疾病支气管动脉形态学变化的研究  

Morphological changes of bronchial arteries in CT angiography with COPD patients

作　　者：施珏倩[1] 于红[1] 范丽[1] 管宇[1] 夏艺[1] 肖湘生[1] 

机构地区：[1]第二军医大学附属长征医院影像科,上海200003

出　　处：《实用放射学杂志》2015年第1期35-38,74,共5页Journal of Practical Radiology

基　　金：国家自然基金面上项目（81271572）;国家自然基金青年基金（81000602）.

摘　　要：目的：探讨慢性阻塞性肺疾病（COPD）所致的支气管动脉（BA）改变及其 CTA 表现特征。方法将43例 COPD 病例依据慢性阻塞性肺疾病全球倡议（GOLD）分为4组（GOLD 1级组,GOLD 2级组,GOLD 3级组,GOLD 4级组）,并随机选取同期来本科就诊的查体健康者10例作为对照组。将所有病例的胸部 CT 增强扫描的原始数据0.625 mm 薄层重建后,对 BA 三维重建。统计各组 BA 的主干及分支计数,评价其形态变化情况,并比较各组间差异。结果与对照组相比,GOLD 2~4级的 BA 主干计数增高（P ≤0.05）,GOLD 3~4级 BA 分支计数增高（P ≤0.05）；与 GOLD 1级组相比,GOLD 4级 BA 主干计数增高（P ≤0.05）, GOLD 3~4级 BA 分支计数增高（P ≤0.05）；其余各组间无统计学差异。与对照组、GOLD 1级组相比,GOLD 3~4级的 BA 形态迂曲,组间差异具有统计学意义（P ≤0.05）。结论 COPD 患者 BA 形态迂曲,CTA 检查显示率高,这种变化在中度或极重度COPD 患者（GOLD 3~4级）中显著。与其他肺部疾病相比,COPD 产生的 BA 改变具有一定的特征性。Objective To determine the change of bronchial artery （BA）caused by COPD and its character on CTA.Methods 43 patients with COPD were collected and divided into 4 groups according to the Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease （GOLD）.10 healthy persons were collected as control group.Data of enhanced chest CT from all cases were collected.In combination with 0.625 mm thin slice reconstruction,MPR,MIP and VR,counted the number of BA （main trunk and branch）,analysised characteristic change of BA in patient with COPD.Results Compared with con-trol group,quantity of main trunk of BA was increased in GOLD 2 -4 （P ≤0.05 ）,and quantity of branch BA was increased in GOLD 3-4（P ≤0.05）.Compared with control group and GOLD 1,morphology of BA was significantly tortuose in GOLD 3-4（P ≤0.05）. Conclusion Tortuosity BA could be observed in patient with COPD.Increased quantity of BA is showed on enhenced CT and 3D re-construcion CT image with the exacerbation of the disease.Character change is significant in those serious and very serious COPD patients （GOLD 3-4）.Feature of BA with COPD is different with other diseases.

关 键 词：慢性阻塞性肺疾病 支气管动脉 计算机体层成像 血管造影术 

分 类 号：R563[医药卫生—呼吸系统] R814.43[医药卫生—内科学]