胸部CT增强扫描结合三维可视化重建技术在靶肺叶和肺段解剖结构显示中的应用价值  

Chest CT enhancement scan combined with three-dimensional visualization reconstruction technique in the illustration of anatomical structure of target lung lobe and lung segment

作　　者：望云[1] 樊荣荣[1] 施晓雷 黄可南[2] 范丽[1] 萧毅[1] 刘士远[1] WANG Yun;FAN Rongrong;SHI Xiaolei;HUANG Kenan;FAN Li;XIAO Yi;LIU Shiyuan(Department of Radiology,Shanghai Changzheng Hospital,Shanghai 200003,China;Department of Cardiothoracic Surgery,Shanghai Changzheng Hospital,Shanghai 200003,China)

机构地区：[1]上海长征医院影像科,上海200003 [2]上海长征医院胸心外科,上海200003

出　　处：《中华实用诊断与治疗杂志》2019年第11期1110-1113,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家重点研发计划政府间合作项目(2016YFE0103000);上海长征医院青年启动基金(2017CZQN14);“金字塔”人才工程优秀住院医师项目

摘　　要：目的探讨胸部CT增强扫描动脉期薄层数据结合三维可视化技术重建显示靶肺叶和肺段肺血管和支气管三维解剖结构的可行性。方法疑诊肺癌拟行胸腔镜下肺叶切除或解剖性肺段切除术患者35例,术前均行胸部CT增强扫描,记录病灶位置、直径、密度类型,并将增强扫描动脉期薄层数据导入图像后处理工作站,对肺血管、支气管和肺结节进行图像分割和融合处理,建立靶肺叶和肺段的三维可视化重建模型,评估图像显示质量,并计算有效三维模型比率。结果胸部CT增强扫描显示病灶位于左肺上叶13例、左肺下叶8例、右肺上叶11例、右肺中叶2例、右肺下叶1例,呈纯磨玻璃密度结节9例、混杂磨玻璃密度结节19例、实性结节7例,病灶直径0.8~4.0(1.94±0.67)cm;35例成功重建包括胸廓、“透明肺”的靶肺叶和肺段的三维可视化立体结构,可任意移动、旋转、缩放、拆分、融合、自定义着色、透明化显示,直观显示病灶与胸廓、肺脏及靶肺叶血管和支气管的空间位置关系;三维可视化模型图像质量评分4分11例,3分为22例,2分1例,1分1例,有效三维模型比率为94.3%。结论胸部CT增强扫描结合三维可视化重建技术能清晰显示靶肺叶和肺段血管、支气管的结构及其与病灶的关系。Objective To investigate the feasibility of thin-slice data of arterial phase in chest CT enhancement scan combined with three-dimensional visualization technique in the reconstruction of three-dimensional anatomy of pulmonary vessels and bronchus in the target lung lobes and lung segments.Methods Thirty-five patients with suspected lung cancer scheduled for thoracoscopic lobectomy or anatomical segmentectomy received chest CT enhancement scan before operation.The location,diameter and density of the lesions were recorded and the thin-slice data of arterial phase in chest CT enhancement scan were imported into the post-processing workstation for image segmentation and fusion process of pulmonary vascular,bronchial and pulmonary nodules,to establish three-dimensional reconstruction model of the target lung lobe and lung segment in order to evaluate the quality of the images and to calculate the proportion of effective 3 D models.Results The enhanced chest CT scan of 35 patients showed that the lesion was located in the left upper lobe of the lung in 13 cases,left lower lobe in 8 cases,right upper lobe in 11 cases,right middle lobe in 2 cases,and right lower lobe in 1 case;9 cases of pure ground glass nodules,19 cases of mixed ground glass nodules and 7 cases of solid nodules,with the lesion diameter of 0.8 to 4.0(1.94±0.67)cm.3 D visualization models of target lung lobe and lung segment were successfully reconstructed in 35 cases,including the thoracic and transparent lung structure,and could visually display the spatial positional relationship between the lesion and the thoracic,lung and target lung vessel and bronchus.The image quality score was 4 in 11 cases,3 in 22,2 in 1 and 1 in 1,with the effective rate of 94.3%.Conclusion Chest CT enhancement scan combined with three-dimensional visualization reconstruction technique could clearly illustrate the anatomical structure of target lung lobe and lung segment as well as the relation with the lesion.

关 键 词：肺 体层摄影术 X线计算机 三维可视化 

分 类 号：R73[医药卫生—肿瘤]