320排CT在支气管动脉性咯血介入治疗中的临床应用  

Clinical application of 320-detector CT in interventional treatment of bronchial artery hemoptysis

作　　者：孙厚长[1] 曹国全[1] 王镇章[1] 许化致[1] 魏培英 

机构地区：[1]温州医科大学附属第一医院放射科,浙江温州325000

出　　处：《实用放射学杂志》2015年第9期1511-1514,共4页Journal of Practical Radiology

基　　金：温州市科技局科技资助项目（Y20120021）.

摘　　要：目的：探讨320排 CT 在支气管动脉性咯血介入治疗中的临床价值。方法回顾分析30例支气管动脉性咯血患者的CTA 及 DSA 图像,观察和记录支气管动脉（BA）的空间解剖关系,如 BA 的分支类型、起源及开口位置等信息。结果30例中,BA分支类型有6型,以 R1 L1型最多,占43.3%；CTA 共显示 BA 83支,右侧38支,左侧45支；右侧 BA 多与右侧肋间动脉共干,开口于降主动脉右侧壁,比例分别为52.6%和78.9%；左侧 BA 多起源于降主动脉或主动脉弓,开口于降主动脉前壁,比例分别为82.2%和62.2%。以气管隆突定位,左右侧 BA 多位于＋2～-1 cm 之间,比例分别为80%和89.5%。CTA 与 DSA 比较,CTA 显示 BA 的敏感度为97.5%,特异度为100%。结论320排 CT 可以很好地显示 BA 的分支类型、起源及开口位置等情况,尤其是能发现异位起源的 BA,可作为大咯血术前常规检查手段及术后评估手段在临床上推广应用。Objective To evaluate the clinical value of 320-detector CT in interventional treatment of bronchial artery hemoptysis. Methods CTA and DSA images of 30 patients with bronchial artery hemoptysis were retrospectively analyzed.Spatial anatomical characters of the bronchial arteries,such as the type of branches,origin and opening positions of the bronchial arteries were observed and recorded.Results In 30 patients,6 bronchial arteries distribution patterns were found,and the most common type was R1 L1 （43.3%）.83 bronchial arteries were identified using CTA,including 38 on the right and 45 on the left.The right bronchial arteries mainly originated from the intercostal artery （52.6%）,while the left bronchial arteries mainly from the descending aorta and aortic arch （82.2%）.The opening positions of right and left bronchial arteries were mainly located at the right wall of the descending aorta （78.9%）,and anterior wall of the descending aorta （62.2%）,respectively.When the cacarina of trachea was used as the reference position,the left and right bronchial arteries were mainly located in the range of above 2 cm to below 1 cm from tracheal bifurcation, accounting for 80% and 89.5%,respectively.Compared with DSA,the sensitivity and specificity of CTA were 97.5% and 100%, respectively.Conclusion 320-detector CT can be used to clearly display the distribution patterns,origin and opening positions of bronchial arteries,and especially to find bronchial arteries with ectopic origin.It is possible to apply 320-detector CT in preoperative routine examination and postoperative evaluation of massive hemoptysis.

关 键 词：支气管动脉 咯血 计算机体层成像 血管造影术 

分 类 号：R441.7[医药卫生—诊断学] R814.42[医药卫生—临床医学]