孤立性肺结节与血管和支气管关系:多层螺旋CT与病理对照初步研究

发布时间：2018-04-02 02:36

  本文选题：孤立性肺结节　切入点：血管　出处：《中国医学计算机成像杂志》2015年02期

【摘要】：目的:研究孤立性肺结节(SPN)与周围血管和支气管的关系,结合SPN的三维CT成像,以期提高对肺结节的良恶性诊断准确率。方法:对经手术和病理证实的26例SPN(其中恶性结节18例,良性结节8例,病灶直径(3.7~31.4mm,平均11.8mm)进行回顾性分析,所有患者做肺部CT常规5mm加局部薄层(1.25mm)重建,观察病灶及周围血管和气管形态并进行分类,经工作站多平面重建(MPR)和曲面重建(CPR)及SPN三维重建软件nodule assessment构成空间三维形态。将分析结果与手术病理对照。结果:手术病理证实良性8例(35.71%),恶性18例(64.29%)。SPN-血管关系分为6型:Ⅰ型,斜形方向血管在病灶边缘截断,末端杵状增粗。Ⅱ型,血管在病灶边缘截断,笔直走行,末端不呈杵状增粗。Ⅲ型,血管进入结节切迹处。Ⅳ型,一支血管穿过结节。Ⅴ型,血管受压呈弧形改变,血管紧贴结节边缘走行。Ⅵ型,为混合型。SPN-气管关系分为6型:Ⅰ型,支气管在SPN边缘中断;Ⅱ型,支气管进入SPN后中断;Ⅲ型,支气管穿过SPN;Ⅳ型,支气管紧贴SPN边缘走行;Ⅴ型,多支支气管向SPN汇聚;Ⅵ型,为混合型。其次,SPN三维重建nodule assessment对SPN形态及SPN与肺血管和胸壁的关系显示更直观,三维CT重建均见肺血管供应症。结论:多层螺旋CT薄层扫描能清楚显示SPN与肺血管和支气管的关系,两者对SPN良恶性性质的诊断和鉴别诊断有重要价值。SPN三维CT重建技术,更能直观反映结节的形态学特征。
[Abstract]:Objective: to study the relationship between solitary pulmonary nodule (SPN) and peripheral blood vessels and bronchi, and to study the relationship between SPNs and SPN. Methods: 26 cases of SPNs proved by operation and pathology were analyzed retrospectively, including 18 cases of malignant nodules, 8 cases of benign nodules, and 3.7 mm of lesion diameter (mean 11.8 mm). All the patients were reconstructed by conventional 5mm and local thin layer (1.25mm). The lesions and their peripheral blood vessels and trachea were observed and classified. SPN 3D reconstruction software nodule assessment and workstation multiplanar reconstruction (MPR) and curved surface reconstruction software (nodule assessment) were used to construct spatial 3D morphology. The results were compared with those of surgery and pathology. Results: 8 cases of benign and 18 cases of malignant were proved benign by operation and pathology, and 18 cases were malignant. SPN- vascularization. The system is divided into 6 types: type 鈪，

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