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目的利用64层螺旋CT血管成像(CTangiography,CTA)研究原发性肺癌供血动脉的三维影像特征及其临床价值。方法对63例行64层螺旋CT胸部增强扫描至少1支支气管动脉(bronchial artery,BA)清晰显示的病例,包括原发性支气管肺癌43例(其中明确病理学证实37例,临床综合诊断6例)及正常对照20例,采用容积显示(volume ren-dering,VR)、多平面重建(multi-planar reformat,MPR)及最大密度投影(maximum intensity projection,MIP)等后处理技术进行三维重建,分析肺癌供血动脉的影像学特征。结果43例原发性肺癌中,全部肿块均可见BA供血,其中8例合并肺外体循环动脉供血。所有供血BA的起源、数目、内径等三维形态学特征均得到清晰显示,其中单支供血型22例(51.2%),8例表现为供血BA主干不同程度扩张迂曲,14例表现为供血BA主干及分支均扩张迂曲,走向或走行至病灶内;多支供血型13例(30.2%),表现为2支或多支BA供血病灶,相互交通吻合形成血管网;多种动脉供血型8例(18.6%),表现为BA和肺外体循环动脉向同一病灶供血。结论原发性肺癌以BA供血为主,可合并肺外体循环动脉供血,64层螺旋CTA能安全、清晰地评价肺癌供血动脉的三维影像特征。
Objective To study the three-dimensional imaging features and clinical value of primary pulmonary artery feeding with 64-slice CT angiography (CTA). Methods Totally 63 cases of primary bronchial carcinoma (including 43 cases of primary bronchial carcinoma) were confirmed by at least one bronchial artery (CT) in 63 cases with 64-slice spiral CT thoracic enhanced scanning (including 37 cases confirmed by pathology and 6 cases with clinical diagnosis ) And normal control (n = 20). Three-dimensional reconstruction was performed using volume ren-dering (VR), multi-planar reformat (MPR) and maximum intensity projection (MIP) Imaging Features of Pulmonary Artery Delivery Artery. Results In 43 cases of primary lung cancer, BA was found in all the masses, of which 8 cases were combined with systemic pulmonary artery supply. All the three morphological features of BA, such as the origin, number and internal diameter of all the blood donors, were clearly shown. Among them, 22 cases (51.2%) had mononuclear donor blood and 8 cases showed varying degrees of tortuous dilatation of BA trunk and 14 cases showed BA trunk And branches were extended tortuosity, walking or walking to the lesion; multi-supply type in 13 cases (30.2%), manifested as two or more branches of BA-feeding lesions, mutual traffic anastomosis to form a vascular network; a variety of arterial blood supply in 8 cases 18.6%), manifested as BA and pulmonary extracorporeal circulation artery to the same lesion blood supply. Conclusion Primary BA is mainly supplied with BA, which can be combined with systemic pulmonary artery supply. The 64-slice spiral CTA can evaluate the 3D imaging features of the feeding artery of lung cancer safely and clearly.