肺癌的CT气管、支气管树三维重建

目的：通过对63例肺癌患者的气管、支气管树三维重建进行回顾性分析，探讨CT气管、支气管树三维重建对肺癌诊断和治疗的意义。材料和方法：收集自1997年10月至2000年2月已证实的肺癌患者共63例，包括中央型肺癌35例，周围型肺癌28例。所有病例均接受了EBCT扫描。扫描条件为130kV/630mA，层厚／间隔分别为3mm/3mm或1.5mm/1.5mm，扫描方式为连续容积扫描（CVS）。三维重建方式为遮盖表面显示法（SSD）。重建阈值为－500Hu--300Hu。结果：EBCT气管、支气管树三维重建显示中央型肺癌引起的气管、支气管树狭窄或闭塞的形态为：42．9％表现为锥状中断，22．9％表现为不规则偏心性狭窄，17．1％表现为杵状中断，14．3表现为截断且断端不规则，2．8％表现为右主支气管的裂开和右上叶支气管的截断。EBCT气管、支气管树三维重建可用于确定病变的准确部位，测定狭窄的范围和程序，可显示周围性肺癌及其与周围结构的关系。结论：EBCT气管、支气管树三维重建对于中央型肺癌和周围型肺癌的诊断和治疗具有一定的辅助作用。

3D Reconstruction of Tracheobronchial Tree with Computed Tomography in Lung Cancers

To evaluate the CT 3D reconstruction of tracheobronchial tree in the diagnosis and treatment of lung cancers by analyzing 63 cases retrospectively.Materials and Method:All the 63 cases were collected from October 1997 to February 2000,they were scanned by EBCT with 130kV and 630mA.The scanning method was continuous volume scan,the slice thickness and interval were 3mm/3mm or 1.5mm/1.5mm.All cross-section images were transmitted to the INSIGHT workstation(Accuimage diagnostics corporation,San Bruno) and reconstructed with SSD(Shaded Surface Display),their threshold setting were -500Hu to -300Hu.Results:3D reconstruction of TBT with EBCT revealed stenoses or obstructions in cases with central lung cancers,including42.9% cases with cone obstructed,22.9% cases pestle obstructed,17.1% cases with eccentric stenoses,11.3% cases interrupted irregularly,and 2.8% cases with right stem destoryed and right upper lobe bronchus obstructed.This technique could be used to locate sites of stenoses and measure stenostic extent and it could reveal peripheral lung cancers and their relation with the adjacent structures.Conclusion:3D reconstruction of TBT with EBCT is helpful for diagnosis and therapy of central and peripheral lung cancer.