MSCT胸部增强与三维重建血管成像在肺隔离症的诊断与分型中的研究

发布时间：2018-05-24 08:31

本文选题：肺隔离症 + MSCT增强　；参考：《大连医科大学》2012年硕士论文

【摘要】：目的：探讨MSCT胸部增强与三维重建血管成像在肺隔离症诊断中的价值，并对肺隔离症的分型进行相关研究。材料和方法：回顾性分析我院自2007年01月至2012年3月诊断肺隔离症的病例18例，其中男性10例，女性8例，年龄16-74岁，平均年龄48岁。患者就诊时咳嗽、咳痰伴胸痛6例；仅有咳嗽症状者3例；咯血3例（咯血量2-20ml）；咳嗽、咳痰、痰中带血丝3例；咳嗽、咳痰、痰中带血块1例；门诊常规体检疑诊并确诊者2例。全部病例均应用GELightspeed Qx/Plus16排螺旋CT行平扫与增强扫描，层厚5mm，螺距0.938:1，重建间隔1.25mm，应用非离子型对比剂（优维显300mg/mL）100mL，以4mL/s流速从肘正中静脉注入，开始注药后延迟20s开始扫描。在ADW4.2工作站应用容积再现（VR）、多层面重组（MPR）及最大密度投影(MIP)等三维重建技术完成血管与病变的重建。应用SPSS11.5统计学软件包进行分析。PS按不同的诊断方式分为两组，比较PS的异常供血动脉采用X2检验分析；比较PS的分型，采用Fisher确切概率法分析。结果：18例肺隔离症患者中，，病灶位于左肺下叶17例、右肺下叶1例；三维重建血管成像技术检出异常供血动脉中发自胸主动脉16例、腹主动脉1例、膈动脉1例；肺隔离症CT表现分型：囊性肿块型4例，实性肿块型6例，囊实混合肿块型2例，局部肺叶内增多、增粗、紊乱的血管结构型6例；病灶内伴有钙化4例，余14例未见钙化灶。患者行手术10例（叶内型8例，叶外型2例），未行手术随访8例（分析诊断叶内型6例，叶外型2例）。 MSCT胸部增强与三维重建血管成像和手术病理在诊断PS的异常供血动脉与分型上，两组之间无统计学意义（P＞0.05）。结论：MSCT胸部增强与三维重建血管成像技术在肺隔离症的诊断中具有重要的应用价值，特别是VR重建技术，可以作为诊断肺隔离症的金标准技术。
[Abstract]:Objective: to investigate the value of MSCT chest enhancement and three dimensional reconstruction angiography in the diagnosis of pulmonary sequestration, and to study the classification of pulmonary sequestration. Materials and methods: 18 cases of pulmonary sequestration diagnosed in our hospital from January 2007 to March 2012 were retrospectively analyzed, including 10 males and 8 females, aged 16-74 years with an average age of 48 years. There were 6 cases of cough, expectoration with chest pain, 3 cases of cough symptoms, 3 cases of hemoptysis (hemoptysis volume 2-20 ml), 3 cases of cough, expectoration and sputum with blood silk in phlegm, 1 case of cough, expectoration, and 1 case of blood clot in phlegm. 2 cases were confirmed by routine physical examination. All cases were scanned by GELightspeed Qx/Plus16 slice spiral CT with slice thickness of 5 mm, pitch of 0.938: 1, reconstruction interval of 1.25 mm, and Nonionic contrast agent (UVX 300mg / mL, 100mL) was injected from the median cubital vein at the flow rate of 4mL/s. The scan was started 20 s after injection. Three-dimensional reconstruction techniques such as volume reconstruction, multilayer recombination and maximum density projection were used to reconstruct blood vessels and lesions in ADW4.2 workstation. PS was divided into two groups according to different diagnostic methods by using SPSS11.5 statistical software package. The abnormal supply arteries of PS were analyzed by X2 test, and the classification of PS was analyzed by Fisher exact probability method. Results among 18 patients with pulmonary sequestration, 17 cases were located in the left lower lobe of lung and 1 case in the right lower lobe, 16 cases were from thoracic aorta, 1 case was abdominal aorta, and 1 case was phrenic artery. There were 4 cases of cystic mass type, 6 cases of solid mass type, 2 cases of cystic solid mass type, 6 cases of regional pulmonary lobe hyperplasia, thickening and disorder vascular structure type, 4 cases with calcification in the focus, and 14 cases without calcification. Operation was performed in 10 cases (8 cases of intra lobar type, 2 cases of extralobar type, 8 cases of non-operative follow-up) (6 cases of intralobar type and 2 cases of extralobar type) were analyzed. There was no significant difference between the two groups in the diagnosis of abnormal supply arteries and types of PS by MSCT chest enhancement, three-dimensional reconstruction angiography and surgery and pathology (P > 0.05). Conclusion MSCT chest enhancement and three-dimensional reconstruction angiography have important application value in the diagnosis of pulmonary sequestration, especially VR reconstruction technology, which can be used as the golden standard in the diagnosis of pulmonary sequestration.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.41

【参考文献】