基于CT三维重建的右上肺奇叶应用解剖研究  

Three-dimensional CT reconstruction-based applied anatomical study of the azygos lobe in the right upper pulmonary lobe

作　　者：曹洪瑜 蒋迎九[2] CAO Hongyu;JIANG Yingjiu(Chongqing Medical University,Chongqing 400016,China;Department of Thoracic Surgery/Cardiovascular Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学,重庆400016 [2]重庆医科大学附属第一医院胸外科/心脏大血管外科,重庆400016

出　　处：《重庆医学》2025年第3期646-651,共6页Chongqing Medical Journal

摘　　要：目的通过CT三维重建分析右上肺奇叶的解剖结构特点。方法选取重庆医科大学附属第一医院2016年3月至2019年3月行胸部薄层CT且诊断为右上肺奇叶的92例患者进行回顾性研究。利用重建模型统计右上肺奇叶的支气管、血管的走行及肺奇叶患者的右肺上叶解剖结构。结果根据肺奇叶支气管起源与叶支气管数量分类,单分支型为主要类型,占76.1%(70/92),其奇叶支气管大多发自B^(1)b或B^(1)a。根据动脉起源分类,仍然以单分支型为主要类型,占72.8%(67/92),其中多数主要发自A~1a,其次为A~1b、A~1a。肺奇叶静脉大多汇入V^(1)a中(68例,占73.9%),其余则汇入V^(1)b中(24例,占26.1%)。根据右肺上叶支气管分支类型,一共有6种,其中三分支型是右肺上叶支气管最常见的解剖类型(B^(1)-B~2-B~3型),占总数的53.3%(49/92)。右肺奇叶的平均体积为(62869.36±45097.76)cm^(3),小于其他肺段的平均体积。肺奇叶体积较大的患者供应支气管一般为双支,平均体积为(120421.41±25294.04)cm^(3),而单分支型肺奇叶的平均体积为(43685.34±31697.77)cm^(3)。结论奇肺叶肺部解剖结构具有多重多类型变异的复杂性,可能存在极为罕见的解剖变异情况。Objective To analyze the anatomical characteristics of the azygos lobe in the right upper lung using three-dimensional CT reconstruction.Methods This retrospective study analyzed 92 patients diagnosed with azygos lobe in the right upper lung through thin-section chest CT at the First Affiliated Hospital of Chongqing Medical University from March 2016 to March 2019.Three-dimensional reconstruction models were utilized to statistically analyze the trajectories of bronchi and vessels in the azygos lobe,and to evaluate the anatomical structures of the right upper lobe in these patients.Results According to the classification based on the origin of the azygos lobe bronchi and the number of lobar bronchi,the unibranched type was predominant,accounting for 76.1%(70/92),with most azygos lobe bronchi originating from B^(1)b or B^(1)a.Regarding arterial origin classification,the unibranched type remained dominant at 72.8%(67/92),primarily originating from A 1a,followed by A 1b and A 1a.Most azygos lobe veins drained into V^(1)a(68 cases,73.9%),while the remainder drained into V^(1)b(24 cases,26.1%).There were six branching patterns of right upper lobe bronchi,with the trifurcated type(B^(1)-B 2-B 3)being the most common anatomical configuration at 53.3%(49/92).The mean volume of the azygos lobe was(62869.36±45097.76)cm^(3),smaller than the average volume of other pulmonary segments.Patients with larger azygos lobe volumes generally had dual bronchial branches,with a mean volume of(120421.41±25294.04)cm^(3),whereas unibranched azygos lobes showed a mean volume of(43685.34±31697.77)cm^(3).Conclusion The pulmonary anatomical structure of the azygos lobe demonstrates and multitype variations in complexity,and may exhibit extremely rare anatomical variants.

关 键 词：三维重建 肺奇叶 解剖结构 右肺上叶血管 

分 类 号：R655.3[医药卫生—外科学]