多层螺旋CT及重建技术对气管主支气管肿瘤的诊断  

Diagnosis of multidetector spiral CT and its reconstruction techniques in trachea and principal bronchus tumors

作　　者：罗明月[1] 单鸿[1] 姜在波[1] 侯志强[2] 李露芳[1] 张建生[1] 谷力加[3] 黄邵洪[3] 金亦[4] 

机构地区：[1]中山大学附属第三医院放射科,广州510630 [2]湖南省安仁县人民医院放射科 [3]中山大学附属第三医院胸外科暨中山大学肺癌研究中心,广州510630 [4]中山大学附属第三医院病理科,广州510630

出　　处：《中华放射学杂志》2003年第12期1156-1160,共5页Chinese Journal of Radiology

摘　　要：目的　探讨多层螺旋CT(multidetectorspiralCT ,MSCT)及其多平面容积重建 (multiplanarvolumereformation ,MPVR)、容积再现 (volumerendering ,VR)和仿真支气管镜 (virtualbronchoscopy ,VB)重建技术对气管、主支气管肿瘤的临床诊断价值。方法　 31例可疑气管、主支气管肿瘤病例 ,进行MSCT薄层扫描 ,回顾性重建原始扫描数据后形成图像重建数据。在AW工作站 ,应用MPVR、VR和VB软件对图像重建数据行后处理重建 ,分别得到MPVR、VR和VB图像。将MSCT原始横轴面图像、MPVR、VR和VB图像显示气管、主支气管肿瘤的结果与手术病理结果进行对照分析。结果　MSCT原始横轴面图像结合MPVR、VR和VB图像 ,显示的气管、主支气管肿瘤部位 (气管 19例 ,右、左主支气管各 6例 )、形态 (窄基底腔内结节型 2例、宽基底腔内结节型 13例、腔内外肿块型 16例 )、内部特征(密度均匀、密度低各 1例 ,强化不明显 ;2 3例鳞癌、3例腺癌密度较均匀 ,强化较明显 ;密度均匀、欠均匀及瘤内点状钙化各 1例 ,强化明显 )、管壁外侵犯情况 (1例仅突破浆膜层 ,1例与不张的右肺组织分界不清 ,14例侵犯范围为 4～ 5 6mm)、管腔狭窄形态 (偏心性 1例 ,不规则 2 6例 ,环状 3例 ,锥状中断 1例 )和程度 (轻度 5例 ,中度 7例 ,重度 19例 ) 。Objective To investigate the clinical diagnostic value of multidetector spiral CT (MSCT) and its reconstruction techniques including multiplanar volume reformation (MPVR), volume rendering (VR), and virtual bronchoscopy (VB) in the trachea and principal bronchus tumors. Methods Thin slice MSCT scanning was performed in 31 patients with suspected trachea or principal bronchus tumors, and image reconstruction data were formed after retro-reconstructing of initial scanning data. MPVR, VR, and VB images were obtained respectively by postprocessing of image reconstruction data with MPVR, VR, and VB image processing software in AW workstation. The findings of MSCT initial axial images, MPVR, VR, and VB images were compared with surgical and pathological results. Results MSCT initial axial images combined with MPVR, VR, and VB images displayed the locations (tracheae, n=19; right principal bronchi, n=6; left principal bronchi, n=6), morphologies (endoluminal nodular tumors with narrow bases, n=2; endoluminal nodular tumors with wide bases, n=13; intraluminal and extraluminal massive tumors, n=16), internal features (1 had homogeneous density, 1 had low density, they both without obvious enhancement; 23 squamous cell carcinomas and 3 adenocarcinomas had fairly homogeneous density and rather obvious enhancement; 1 had homogeneous density, 1 had inhomogeneous density, 1 had punctate calcification, all with obvious enhancement), extramural invasion situations (broke through only serous membrane, n=1; no clear border with right atelectatic lung tissue, n=1; ranges of extramural invasion 4-56 mm, n= 14), morphologies of luminal stenoses (eccentric, n=1; irregular, n=26; circular, n=3; conical interruption, n=1), extents (mild, n=5; moderate, n=7; severe, n=19); measured longitudinal invasion ranges (only 3 mm, n=1; invaded the whole right principal bronchus wall and carina, n=1; 5-68 mm, n=29), and distances between principal bronchus tumors and carina (invaded carina, n=1; 16 mm, n=1; longer than 20 mm, n=10). The results

关 键 词：多层螺旋CT 气管主支气管肿瘤 诊断 多平面容积重建 仿真支气管镜 

分 类 号：R734.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]