副心支气管的流行病学与CT影像特征  

Epidemiology and CT radiological characteristics of accessory cardiac bronchus

作　　者：茆莉 刘杜娟 倪建明 张英 潘山 孟善进 Mao Li;Liu Dujuan;Ni Jianming;Zhang Ying;Pan Shan;Meng Shanjin(Department of Radiology,the Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University,Wuxi 214002,China;Department of Radiology,Guanyun County People's Hospital,Lianyungang 222200,China)

机构地区：[1]南京医科大学附属无锡第二医院影像科,无锡214002 [2]江苏省灌云县人民医院影像科,连云港222200

出　　处：《中华解剖与临床杂志》2024年第7期444-450,共7页Chinese Journal of Anatomy and Clinics

基　　金：无锡市卫健委重大项目(Z202209);无锡市“太湖之光”科技攻关项目(Y20232029)。

摘　　要：目的调查副心支气管(ACB)的流行病学与CT影像特征。方法横断面研究。纳入南京医科大学附属无锡第二医院2022年11月—2023年2月行常规胸部螺旋CT扫描的11088例患者的临床和影像资料,其中男5764例、女5324例,年龄2~101(52.5±19.4)岁。观察指标:(1)统计ACB的患病率及性别分布等;(2)观察ACB的起源、分支方向、形态和其他影像学特点,测量比较不同分型ACB的最大直径、长度、距离气管隆突距离、与中间段支气管的夹角(分支角度)之间的差异;(3)基于CT影像的其他异常发现。结果(1)11088例患者中,共检出32例ACB,患病率为0.29%。32例ACB患者中,25例男性、7例女性,男女比为3.6∶1;男女患病率分别为0.43%和0.13%,差异有统计学意义(χ2=8.79,P=0.003)。(2)ACB起源于右侧中间段支气管内侧壁27例(84%,27/32),起源于右主支气管5例(16%,5/32);分支方向为后内侧18例(56%,18/32),内侧13例(41%,13/32),前内侧仅1例(3%,1/32)。根据形态,32例ACB患者分为憩室型(Ⅰ型)19例(59%)、囊变型(Ⅱ型)5例(16%)、通气型(Ⅲ型)8例(25%)。ACB的最大直径为5.2~13.5(9.2±2.0)mm,长度为6.0~23.8(12.7±4.5)mm,距气管隆突距离为12.6~29.2(22.6±4.7)mm,分支角度为32.4°~90.7°(56.3°±16.9°)。Ⅰ型、Ⅱ型、Ⅲ型ACB的长度分别为(10.6±2.6)、(13.8±2.1)、(16.9±6.0)mm,3种类型间总体比较,以及Ⅰ型、Ⅲ型间比较,差异均有统计学意义(P值均<0.05);而3种分型ACB的最大直径、距离气管隆突距离、分支角度比较,差异均无统计学意义(P值均>0.05)。(3)32例ACB中,2例见气管内黏液栓形成,1例合并右上气管支气管,1例伴有左肺下叶上副裂,1例右侧水平裂缺失。4例患者进行过增强CT扫描,其中1例发现主动脉夹层(DeBakeyⅢ型)同时合并右侧奇裂。结论ACB的患病率为0.29%,其中男性患病率为0.43%,女性患病率为0.13%,存在明显的性别差异。ACB主要起源于右中间段支气管,以后内侧分支较多;根据形态可ObjectiveThis study aimed to investigate the prevalence of accessory cardiac bronchus(ACB)and describe its clinical and CT radiological characteristics.MethodsA cross-sectional study was conducted,including clinical and imaging data of 11088 patients who underwent routine chest CT examinations at the Affiliated Wuxi Second Hospital of Nanjing Medical University from November 2022 to February 2023.Of the patients,5764 were males and 5324 were females,with an age range of 2-101(52.5±19.4)years.The observation indices were as follows:(1)the prevalence of ACB and its distribution in gender;(2)the origin,branching direction,morphology,and other radiological features of ACB.Differences in maximum diameter,length,distance from the carina,and branching angle among different types of ACB were measured and compared.(3)Other abnormal findings were based on CT imaging.ResultsAmong the 11088 patients,32 cases of ACB were detected,with a prevalence of 0.29%.Of the 32 patients,25(0.43%)were male and 7(0.13%)were female,with a male-to-female ratio of 3.6∶1,the difference was statistically significant(χ2=8.79,P=0.003).ACB originated from the medial wall of the right intermediate bronchus in 27 cases(84%,27/32)and from the right main bronchus in five cases(16%,5/32).The branching direction was predominantly posterior-medial(56%,18/32)and medial(41%,13/32),with only one case(3%,1/32)showing anterior-medial branching.Based on the morphology,the 32 cases of ACB were classified into diverticulum type(TypeⅠ,59%),cystic type(TypeⅡ,16%),and ventilatory type(TypeⅢ,25%).The maximum diameter of ACB was 5.2-13.5(9.2±2.0)mm;the length was 6.0-23.8(12.7±4.5)mm;the distance to carinal was 12.6-29.2(22.6±4.7)mm,and the branch angle was 32.4°-90.7°(56.3°±16.9°).The average lengths of TypeⅠ,TypeⅡ,and TypeⅢACB were(10.6±2.6)mm,(13.8±2.1)mm,and(16.9±6.0)mm,respectively,showing statistically significant differences(all P values<0.05).However,no statistically significant differences in diameter,distance from the tracheal car

关 键 词：呼吸系统畸形 支气管畸形 副心支气管 流行病学研究 体层摄影术 螺旋计算机 

分 类 号：R816.4[医药卫生—放射医学] R562[医药卫生—临床医学]