基于CT三维重建技术对肺部病变患侧肺段支气管解剖类型及变异情况的影像学观察  

Observation of the anatomical types and variations of pulmonary segment bronchus on the side of pulmonary lesions based on multi-slice spiral CT three-dimensional reconstruction technique

作　　者：胡义 阿卜拉·努尔麦麦提 穆热迪力·麦麦提阿卜杜拉 张力为[1] 张海平[1] Hu Yi;Nurmamat Abla;Mamatabdulla Muradil;Zhang Liwei;Zhang Haiping(Department of Thoracic Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院胸外科,乌鲁木齐830054

出　　处：《中华解剖与临床杂志》2023年第6期365-375,共11页Chinese Journal of Anatomy and Clinics

摘　　要：目的探讨基于CT三维重建影像的肺部病变患者病灶侧肺段支气管的解剖类型与变异情况。方法横断面研究。纳入2019年12月—2022年8月新疆医科大学第一附属医院胸外科行胸部薄层增强CT扫描的615例患者的影像资料,其中男250例、女365例,年龄38~70岁(中位年龄58岁)。615例患者中,肺癌488例,肺结核及肺部其他炎性病变127例。CT检查显示病变部位:右肺359例,其中右肺上叶205例、中叶43例、下叶111例;左肺256例,其中左肺上叶184例、下叶72例。根据患者CT扫描数据重建患侧肺支气管和血管,观察统计患侧各肺段支气管的解剖类型及解剖变异情况。结果(1)右肺359例:a)右肺上叶支气管解剖类型分为3种类型,两分支型105例(29.2%)、三分支型233例(64.9%)、四分支型11例(3.1%);三分支型中的B^(1),B^(2),B^(3)亚型215例(59.9%)是右肺上叶支气管最常见的解剖类型。此外,观察到10例(2.8%)少见解剖变异。b)右肺中叶支气管解剖类型分为3种类型,两分支型343例(95.5%)、三分支型15例(4.2%)、四分支型1例(0.3%);两分支型中的B^(4),B^(5)亚型332例(92.5%)是右肺中叶支气管最常见的解剖类型。此外,发现27例(7.5%)右肺中叶B^(4),B^(5)空间位置关系类似于左肺上叶B^(4),B^(5)亚型。c)右肺下叶背段支气管解剖类型分为3种类型,单分支型353例(98.3%)、双分支型5例(1.4%)、三分支型1例(0.3%);单分支型又分为双分叉亚型248例(69.1%)、三分叉亚型105例(29.2%),其中双分叉亚型中B^(6)b,B^(6)a+c型114例(31.8%)是右肺下叶背段支气管最常见的解剖类型。右肺下叶内侧基底段支气管分为6种亚型,其中B^(7)a型215例(59.9%)最常见。右肺下叶前侧、外侧、后侧基底段支气管解剖类型分为4种类型,其中B^(8),B^(9)+B^(10)型261例(72.7%)最常见。右肺下叶发现星段支气管(B^(*))124例(34.5%),根据B^(*)分支数目分为单分支型114例(31.7%),双分支型10例(2.8%);根据B^(*)起始部�Objective This study aimed to investigate the anatomical types and variations of segmental bronchi on the side of pulmonary lesions based on CT three-dimensional reconstruction.Methods The cross-sectional study was conducted The imaging data of 615 patients who underwent chest thin-layer enhanced CT examination in the Department of Thoracic Surgery,the First Affiliated Hospital of Xinjiang Medical University from December 2019 to August 2022 were included,including 250 males and 365 females,aged 38-70 years(median age=58 years).Among the 615 patients,488 cases were lung cancer,and 127 were tuberculosis and inflammation.CT examination showed that the lesions were located in the right lung in 359 cases,including 205 cases in the upper lobe,43 in the middle lobe,and 111 in the lower lobe.A total of 256 cases were left lung,including 184 of left upper lobe and 72 of left lower lobe.The bronchi and blood vessels of the affected lung were reconstructed according to the CT scan data of the patients.The anatomical types and anatomical variations of bronchi of each segment of the lung on the affected side were observed and counted.Results(1)A total of 359 cases were right lung.a)The anatomical types of the right upper-lobe bronchus were divided into three types:105(29.2%)of double-branch type,233(64.9%)of triple branch,and 11(3.1%)of quadruple branch.Among the three branch types,the B^(1),B^(2),B^(3) subtype was the most common anatomical type in the upper lobe of the right lung,with 215 cases(59.9%).Moreover,10 cases(2.8%)of rare anatomical variations were observed.b)The anatomical types of the right middle-lobe bronchus were divided into three types:343(95.5%)of double branch,15(4.2%)of triple branch,and 1(0.3%)of quadruple branch.Among the two branch types,the B^(4),B^(5) subtype(332 cases,92.5%)was the most common anatomical type of the right middle-lobe bronchus.In 27 cases(7.5%),the spatial relationship of the B^(4),B^(5) type in the right middle lobe was similar to that of the B^(4),B^(5) type in the left upper lob

关 键 词：支气管 解剖 体层摄影术 螺旋计算机 三维重建 

分 类 号：R563[医药卫生—呼吸系统]