多层螺旋CT成像技术在诊断与慢性阻塞性肺疾病相关的支气管变异中的应用价值  

The application value of multi spiral CT imaging technology in the diagnosis of bronchial variation associated with chronic obstructive pulmonary disease

作　　者：郝丽娇 王新文[2] 柴夏宁 郭雅君 杨敏 赵继敏 HAO Lijiao;WANG Xinwen;CHAI Xianing;GUO Yajun;YANG Min;ZHAO Jimin(Department of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China;Department of Imaging,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学医学影像学系,山西太原030001 [2]山西医科大学第二医院影像科,山西太原030001

出　　处：《实用放射学杂志》2023年第10期1583-1587,共5页Journal of Practical Radiology

摘　　要：目的探讨多层螺旋CT(MSCT)多种后处理技术在诊断与慢性阻塞性肺疾病(COPD)相关的支气管变异中的应用价值。方法回顾性分析400例胸部正常者(正常组)的段支气管分支情况,将正常组与200例COPD患者(COPD组)的支气管变异率进行比较。运行多平面重建(MPR)、最小密度投影(MinIP)、容积再现(VR)和CT仿真支气管镜(CTVB)4种后处理技术,测量47例正常组的副背段支气管(B*)开口处管腔的最小径(LD_(min))、最大径(LD_(max))、管腔面积(LA)和距背段支气管的长度(L_(B*-B6)),同时测量4种技术可视B^(*)最远端管腔平均直径(LD_(Avg))和长度(L_(B*)),比较它们的诊断效能。结果正常组段支气管分支情况表现出强烈的个体差异。COPD组B*及右侧B*发生率均高于正常组,差异均有统计学意义(P<0.05)。左侧B^(*)的L_(B*-B6)大于右侧,差异有统计学意义(P<0.05)。无论是LD_(Avg)还是L_(B*),MPR与VR、MinIP、CTVB三者之间和MinIP与VR、CTVB两者之间差异均有统计学意义(P<0.05)。结论MSCT多种后处理技术可以对支气管变异进行可视化及定量评估,为支气管变异CT定量研究提供正常参考值,并证实支气管变异与COPD的发生有一定的相关性。Objective To explore the application value of multiple post-processing techniques of multi spiral computed tomography(MSCT)in the diagnosis of bronchial variation associated with chronic obstructive pulmonary disease(COPD).Methods The segmental bronchial branches of 400 cases of normal chest(normal group)were retrospectively analyzed,and the bronchial variation rate of normal group and 200 cases of COPD patients(COPD group)were compared.Four post-processing techniques including multiplanar reconstruction(MPR),minimum intensity projection(MinIP),volume rendering(VR)and CT virtual bronchoscope(CTVB)were used to measure the lumen minimum diameter(LD_(min)),lumen maximum diameter(LD_(max)),lumen area(LA)and the length from superior segmental airway(L_(B*-B6))at the opening of the subsuperior segmental airway(B^(*))in 47 cases of the normal group.Four techniques were assessed simultaneously to visualize the lumen average diameter(LDAvg)and the length of the most distal lumen of B^(*)(L_(B*)),then their diagnostic efficiency were compared.Results The segmental bronchial branches of the normal group showed strong individual differences.The incidences of B* and the right B* in the COPD group were higher than those in the normal group,and the difference was statistically significant(P<0.05).L_(B*-B6) on the left side of B* was larger than the right side,and the differences were statistically significant(P<0.05).The differences between MPR and VR,MinIP,and CTVB,between MinIP and VR,CTVB were statistically significant for both LDAvg and L_(B*)(P<0.05).Conclusion MSCT multiple post-processing techniques allow visualization and quantitative assessment of bronchial variation,provide normal reference values for quantitative CT studies of bronchial variation,and confirm a correlation between bronchial variation and the development of COPD.

关 键 词：慢性阻塞性肺疾病 支气管变异 CT后处理技术 

分 类 号：R563.4[医药卫生—呼吸系统] R562.2[医药卫生—内科学] R814.42[医药卫生—临床医学]