基于活体CT数据的成人右肺动脉分支形式及其临床意义  

Classification and clinical significance of the branching patterns of the right pulmonary arteries based on the intravital CT data

作　　者：刘海蓝 梅艺璇 张翼 柳澄 刘树伟 LIU Hai-lan;MEI Yi-xuan;ZHANG Yi;LIU Cheng;LIU Shu-wei(School of Basic Medical Sciences,Institute for Sectional Anatomy and Digital Human,Shandong University,Ji’nan 250012,China;Shandong Provincial Hospital Affiliated to Shandong First Medical University,Ji’nan 250021,China)

机构地区：[1]山东大学基础医学院断层解剖学与数字人研究院,济南250012 [2]山东第一医科大学附属省立医院,济南250021

出　　处：《解剖学报》2023年第4期453-459,共7页Acta Anatomica Sinica

基　　金：山东省科技厅重大科技创新工程项目(2019JZZY020106);山东省科技厅重大科技专项(2015ZDXX0201A02)。

摘　　要：目的 对三维重建下的右叶肺动脉的分支类型进行追踪与统计,并探讨其临床意义。方法 应用血管容积重建后处理技术对350例肺血管造影图像进行处理,并根据血管三维显示图像对肺动脉分支形式进行分类与统计。结果 右肺上叶肺动脉分成6种类型,分别为单支前干+后升支型、单支前干型、单只前干+前升支+后升支型、单支前干+前升支型、上前干+下前干型、上前干+下前干+后升支型;中叶分为单干和双干2种类型;下叶的上段动脉分为单干、双干、3干3种类型,基底段动脉分为内侧(基)底段动脉+前(基)底段动脉+外后(基)底段动脉、内前(基)底段动脉+外后(基)底段动脉型以及内侧(基)底段动脉+前外侧(基)底段动脉+后段(基)底段动脉型。总之,右肺上叶、中叶和下叶占据最多的类型分别是单前干+后升支(56.6%)、单干的中叶动脉(57.4%)和单干的上段动脉+内侧底段动脉+前底段动脉+外后底段动脉共干(32.5%)。结论 通过大数据下肺血管造影三维重建结果将右肺动脉分支类型进行了明确地分类与统计,有助于肺部肿瘤的外科精准治疗。Objective To track and make statistics of the right pulmonary arteries’branches and to study the clinical significance.Methods Technologies of vascular volume rending were used to analyze the 350 CT pulmonary angiography images.And the three⁃dimensional display was used to classify the pulmonary arteries.Results According to the 350 reconstructed result,the right upper pulmonary arteries were divided into 6 types:anterior trunk+post ascending artery,anterior trunk,anterior trunk+anterior ascending artery+post ascending artery,superior anterior trunk+inferior anterior trunk+post ascending artery,anterior trunk+anterior ascending artery and superior anterior trunk+inferior anterior trunk.The right middle pulmonary arteries were divided into 2 types:one branch and two branches.As for the right lower pulmonary arteries,the apical arteries were divided into 3 types:one branch,two branches and three branches.The basal segmental arteries were divided into 3 types:medial basal segmentalartery+anterior basal segmental artery+lateroposterior basal segmental artery,medioanterior basal segmental artery+lateroposterior basal segmental artery and medial basal segmental artery+anterior and lateral basal segmental artery+posterior basal segmental artery.To be specific,anterior trunk+post ascending artery type(56.6%)occupied the most in the right upper pulmonary arteries.The majority type of right middle pulmonary artery was one branch(57.4%).In the right lower pulmonary arteries,apical artery of the lower lobe(one branch)+medial basal segmental artery+anterior basal segmental artery+lateroposterior basal segmental artery type(32.5%)was most common.Conclusion The classification of the right pulmonary arteries based on the three dimensional reconstruction of CT pulmonary angiography is of significant to surgical precision therapy of lung tumor.

关 键 词：肺动脉 肺动脉造影 容积重建 解剖学 人 

分 类 号：R813[医药卫生—放射医学] R322.3[医药卫生—临床医学]