128层螺旋CT支气管动脉三维成像解剖特征及临床意义

目的应用128层螺旋cT血管造影研究支气管动脉（BA）的三维解剖特征及其临床应用意义。方法对79例患者行胸部增强扫描，至少1支BA清晰显示病例，采用容积再现（VR）、薄层VR、多平面重组（MPR）、最大密度投影（MIP）、薄层MIP等后处理技术，通过薄层轴位图像及重建图像观察和分析BA的相关三维解剖学特征。结果79例患者中，BA共清晰显示189支，其中右侧99支，左侧90支；较为常见的是R，L，（59．4％，47／79），R2L1（17．7％，14／79）；右BA主要起源于右肋间后动脉（80．O％，79／99）和胸主动脉（18．0％，18／99）。开口位于胸主动脉的右侧壁，右前侧壁及前壁，左BA主要起源于胸主动脉（92．O％，83／90），开口位丁胸主动脉的前壁及前侧壁，BA左右共干起源的24支，开口于胸主动脉前壁，异位起源的9支（0．05％，9／189）。结论128层螺旋cT血管造影可清晰显示BA，有效评价BA的三维影像解剖特征，为临床诊断及治疗提供清晰的BA三维解剖资料。

The three-dimensional anatomic features and the clinical value of bronchial arteries with 128-slice spiral CT

Objective To evaluate three-dimensional（3D） anatomic features of bronchial arterics（BA） and its clinical significance with 128-slice spiral CT angiography. Methods At least 1 BA was clearly displayed in 79 cases who received contrast-enhanced CT of the chest. The spatial anatomical characters were observed by volume rendering （VR）, thin-layer VR, multiple planar reconstruction （MPR）, maximum intensity projection （MIP）, thin-layer MIP, etc. The 3D anatomic features of BA were analyzed through thin-layer axial images and reconstructed images. Results Of all 79 cases, 189 BA were clearly displayed with 99 in the right and 90 in the left. The R1LI （59.4%, 47/79） and R2L1 （17.7%, 14/79） were commonly seen as BA distribution patterns. The right BA mainly originated from the right posteri- or intercostal artery （80.0%, 79/99） and thoracic aorta （18.0%, 18/99） which ariscd from the right side wall of the tho racic aorta , as well as the right anterior wall and anterior wall. The left BA mainly originated from thoracic aorta （92.0%, 83/90）, which arised from anterior wall and anterior side wall. Twenty-four cases had the common trunks which arised from the anterior wall of thoracic aorta. Nine bronchial arteries with variations in their origination were found （0.05%,9/189）. Conclusion The 128-slice spiral CT angiography can clearly display and effectively evaluate the anatomical features of 3D image of BA, and provide clear 3D anatomical data for clinical diagnosis and treatment.