气管性支气管的流行病学与CT影像特征  

Epidemiological and CT imagine adiologic characteristics of tracheal bronchus

作　　者：刘杜娟 任冉 朱铭飞 刘洋 谢常坤 倪建明 Liu Dujuan;Ren Ran;Zhu Mingfei;Liu Yang;Xie Changkun;Ni Jianming(Department of Radiology,the Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University,Wuxi 214002,China;Department of Radiology,Jiangyin Qingyang Hospital,Jiangyin 214401,China;Department of Radiology,the Affiliated Yixing People's Hospital of Jiangsu University,Yixing 214221,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]江苏省江阴市青阳医院影像科,江阴214401 [3]江苏大学附属宜兴医院,宜兴214221

出　　处：《中华解剖与临床杂志》2024年第11期722-727,共6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:探讨基于胸部多层螺旋CT(MSCT)气管性支气管(TB)的流行病学特征和影像学特征。方法:横断面研究。纳入2023年1—12月南京医科大学附属无锡第二医院体检中心行胸部低剂量MSCT检查的16 771例体检者的影像资料。其中男8 913例、女7 858例,年龄18~98(43.7±13.7)岁。图像后处理方法包括最小密度投影、最大密度投影、多平面重组、三维容积再现和虚拟气管镜检查。观察指标:(1)统计TB的检出率、性别及侧别分布情况。(2)观察TB的分型情况,分别在两种不同分型方法中比较不同分型TB的直径、距离气管隆突距离、分支角度的差异。(3)统计胸部MSCT中检出TB合并其他畸形或变异情况。结果:(1)16 771例中检出TB患者107例,检出率为0.64%。107例中,男50例、女57例,男女比为1∶1.14;男性检出率0.56%(50/8 913),女性检出率0.73%(57/7 858),二者比较差异无统计学意义( χ^(2)=1.78, P=0.182)。107例TB均发生在右侧肺,侧别间检出率比较差异有统计学意义( χ^(2)=107.34, P<0.001)。(2)依据Conacher分型方法,107例TB检出者中Ⅰ型14例(13.1%),Ⅱ型42例(39.3%),Ⅲ型51例(47.7%);其中98例(91.6%)TB分支起源于气管外侧壁,9例(8.4%)起源于气管后壁。依据Berrocal分型方法,107例TB检出者中移位型为99例(92.5%),包括“猪支气管”36例(36.4%,36/99)、右肺上叶尖段移位27例(27.2%,27/99)、右肺上叶尖前段移位36例(36.4%,36/99),另外8例(7.5%)为额外型。两种分型方法中,不同性别间TB分型差异均无统计学意义( P值均>0.05)。Conacher分型中,Ⅰ~Ⅲ型TB的直径呈增大趋势,TB距离气管隆突距离、分支角度呈减小趋势,差异均有统计学意义( F=7.40、207.06、24.00, P值均<0.05)。Berrocal分型中,移位型TB的直径小于额外型,距离气管隆突距离、分支角度均大于额外型,差异均有统计学意义( Z=3.44、4.02、4.31, P值均<0.001)。(3)107例TB中,合并肺裂变异42例,合并气道狭窄1例。未发Objective This study aimed to investigate the epidemiologic and radiologic features of tracheal bronchus(TB)on the basis of multislice spiral CT(MSCT)of the chest.Methods This was a cross-sectional study.Imaging data of 16771 physical examiners who underwent low-dose MSCT of the chest at the Physical Examination Center of the Second Hospital of Wuxi affiliated to Nanjing Medical University from January to December 2023 were included.The physical examiners comprised 8913 males and 7858 females,aged 18-98(43.7±13.7)years.Image post-processing methods included minimum intensity projection,maximum intensity projection,multi-plane recombination,three-dimensional volume reconstruction and virtual bronchoscopy.The observation indexes were as follows:(1)statistics on the detection rate,gender,and lateral distribution of TB;(2)observation of TB type and comparison of the differences in diameter,distance from tracheal bulge,and branching angle of differently subtyped TB;(3)statistics on the combined abnormalities or variants of TB detected in chest MSCT.Results(1)TB was detected in 107 out of 16771 physical examiners,with a detection rate of 0.64%.Fifty men and 57 women were identified in the 107 cases of TB,with a male-to-female ratio of 1:1.14,and the detection rates were 0.56%(50/8913)in men and 0.73%(57/7858)in women;the difference in the detection rates of TB between different genders was statistically insignificant(χ^(2)=1.78,P=0.182).All 107 cases of TB occurred in the right lung,and the difference between sides was statistically significant(χ^(2)=107.34,P<0.001).(2)According to Conacher's typing method,among the 107 TB cases,14 cases(13.1%)were of typeⅠ,42 cases(39.3%)were of typeⅡ,and 51 cases(47.7%)were of typeⅢ;98 cases(91.6%)of the TB branches originated from the lateral wall of the trachea,and 9 cases(8.4%)originated from the posterior wall of the trachea.From the Berrocal typing method,99 cases(92.5%)of the 107 TB detections were of the displaced type,of which 36 cases(36.4%,36/99)were"pig bronchus,"

关 键 词：呼吸系统畸形 支气管畸形 气管性支气管 流行病学研究 体层摄影术 螺旋计算机 影像解剖学 

分 类 号：R562.2[医药卫生—呼吸系统] R816.4[医药卫生—内科学]