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目的:探讨多层螺旋CT(MSCT)和多平面重建(MPR)显示肺隔离症异常血管的价值,分析肺隔离症的临床病理特征并通过复习文献提高对肺隔离症的认识和诊断水平。方法:搜集经手术病理、主动脉造影证实的15例肺隔离症患者,均摄胸部正侧位片,13例行平扫及增强扫描(其中5例行螺旋动态增强CT扫描),6例行磁共振成像MRI检查,3例行血管造影。结果:胸部平片表现为肺内结节、团块状影9例及囊性病变6例。CT示含气体或液体的囊肿或软组织肿块13例,病变为肺气肿所包裹5例。螺旋CT对异常供血血管显示率93%,高于普通CT检查60%。MRI中4例为软组织结节或肿块,2例为含气囊肿,3例显示出异常的主动脉供血血管。结论:胸部X线平片对肺隔离症的发现及定位有价值,CT(尤其是螺旋CT动态增强扫描)及MRI取代血管造影立体地显示主动脉异常供血血管,且对肺部病变的评价具有优越性,是肺隔离症的最佳影像学检查手段。
Objective: To investigate the value of multi-slice spiral CT (MSCT) and multiplanar reconstruction (MPR) in displaying the abnormal blood vessels of pulmonary sequestration and to analyze the clinicopathological features of pulmonary sequestration and to improve the understanding and diagnosis of pulmonary sequestration by reviewing the literature. Methods: Fifteen patients with pulmonary sequestration confirmed by pathology and aortic angiography were enrolled in this study. Thoracotomy was performed in 13 patients. Thirteen patients underwent plain scan and contrast-enhanced scan (of which 5 patients underwent helical dynamic contrast-enhanced CT scan) and 6 patients Magnetic resonance imaging MRI examination, 3 cases angiography. Results: Plain radiographs showed pulmonary nodules and masses in 9 cases and cystic lesions in 6 cases. CT showed gas or liquid cysts or soft tissue mass in 13 cases, lesions were emphysema wrapped in 5 cases. Spiral CT abnormal blood vessels showed 93%, higher than 60% of ordinary CT examination. Four of the MRIs were soft tissue nodules or lumps, two were cyst-containing and three showed abnormal aortic blood vessels. Conclusions: The value of chest radiography in the diagnosis and localization of pulmonary sequestration is valuable. CT (especially spiral CT dynamic contrast-enhanced scan) and MRI instead of angiography show the aortic abnormal blood supply vessels stereoscopically, and the evaluation of lung lesions has Superiority is the best imaging method for pulmonary sequestration.