CT重建及合适的窗宽窗位显示肺移植术后吻合口狭窄  

Indication of Airway Stenosis After Lung Transplantation by MSCT Reconstruction Based on Fitted Window Width and Window Level

作　　者：陈琼珠[1] 蓝日辉[1] 夏亭亭[1] 曾庆思[1] 

机构地区：[1]广州医科大学附属第一医院放射科,广东广州510120

出　　处：《中国CT和MRI杂志》2017年第1期37-40,共4页Chinese Journal of CT and MRI

摘　　要：目的用冠状位重建及合适的窗宽窗位显示肺移植术后吻合口狭窄。方法回顾性分析110例肺移植后不同时期患者的胸部MSCT图像,抽取临床确诊和怀疑吻合口狭窄共37例患者的72次CT图像,对轴位CT图像行冠状位重建,以及调节合适的窗宽窗位显示吻合口狭窄的情况。比较轴位肺窗图像与调节窗宽窗位后的冠状位图像两者检出吻合口狭窄的情况,两种图像分别由三位有经验的主治以上医师阅片判断有否气道狭窄,结果用ROCFIT软件进行ROC(受试者操作特征曲线)分析,并用Excel 2010绘制ROC曲线图。结果冠状位合适的窗宽窗位图像的ROC曲线下面积大于肺窗轴位图像的ROC曲线下面积。轴位图像的截距(a值)为0.6916,斜率(b值)为1.0441,曲线下面积(Az)为0.6838;冠状位图像的a值为0.7856,b值为0.9952,Az为0.7112。两种图像诊断的ROC曲线及Az明显不同,两者有显著差异,配对t检验,(P<0.001)。结论肺移植后患者MSCT肺部检查,冠状位重建及合适的窗宽窗位图像可以更敏感地发现吻合口狭窄,而且还能显示狭窄段支气管与邻近大血管的关系,为临床早期诊断和治疗提供依据。Objective To discuss the indication of airway stenosis in a consecutive series of bronchial anastomosis after lung transplantation in our hospital. Methods We performed a retrospective imaged study on 110 cases of lung transplants in our hospital from January 2003 to April 2016. Sixty-two cases were subjected to single lung transplants, and fortyeight to bilateral sequential single Iung transp Iantation. There were totally l58 bronchial anastomoses. 72 MSCT imaging which confirmed or suspected anastomosis stenosis were selected to further handle from 37 cases. Changed the axial to coronal section, then adjusted the window width and window level were fitted to show the airway stenosis. Compared the ability of distinguish airway stenosis between this two kinds of images, three experience physician readed this two groups imaging using ROC analysis. ROC curved was made by Excel 2010. All recipients received long-term MSCT follow-up. Fibrobronchoscopic examinations were done when necessary. Results ROC analysis indicated that there were significant difference（P0.001） between coronal and axial imaging groups with a=0.7856, b=0.9952, Az=0.7112 on the former and a=0.6916, b=1.0441, Az=0.6838 on the latter. Conclusion Reconstruction Coronal imaging can more effectively show airway stenosis after lung transplantation than the axial ones.

关 键 词：肺移植 狭窄 体层摄影术 X线计算机 

分 类 号：R816.41[医药卫生—放射医学]