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目的:研究肺段在冠状断面上的划分及分布。方法:利用20例胸部连续冠状断层标本、2例多层螺旋CT图像、5侧游离肺剥离标本和7侧肺管道铸型,追踪观察了肺叶和肺段的支气管、肺动脉和肺静脉,并据此在冠状断面上划分了肺段。结果:肺段主要分布于从胸骨角至脊柱的10个断面里,气管杈层面是在冠状断面上划分肺段的最佳开始层面。在冠状断面上有6个划分肺段的关键层面:①升主动脉层面,划分肺段的标志性结构尖段静脉、外侧段静脉、尖后段静脉、左前段静脉和上舌段静脉均出现;②肺动脉杈层面,于肺动脉权下方可见到左、右上肺静脉,在11例(55％)标本中出现尖后段静脉、前段静脉和舌静脉干同时汇入左上肺静脉的情形;③气管杈层面,左、右肺上叶支气管及其分支显示清晰,于气管杈下方可见到左、右下肺静脉汇入左心房;④中间支气管层面,可见到两肺下叶肺段支气管、肺动脉和肺静脉的起源;⑤胸主动脉层面,主要为两肺上段和外后底段的支气管和血管;⑥脊柱层面,两肺下叶主要表现为上段、外侧底段和后底段的支气管和血管。结论:通过仔细辨认肺段支气管、肺动脉和肺静脉,可在冠状断面上精确划分肺段。
Objective: To study the division and distribution of pulmonary segments in coronal section. Methods: The bronchial, pulmonary and pulmonary veins of lung and lung were traced by using 20 cases of thoracic continuous coronal tomography, 2 cases of multi-slice spiral CT, 5 cases of free lung detachment and 7 sides of pulmonary duct. Divided the coronal section of the lung segment. Results: The pulmonary segments were mainly distributed in 10 cross-sections from the sternum to the spine. The level of the tracheal twigs was the best starting level for segmenting the pulmonary segments on the coronary cross-section. In the coronal section, there are 6 key segments that divide the pulmonary segments: (1) The ascending aorta level, the landmark structure of the segmental pulmonary segments are the apical segment, lateral segment vein, apical segment vein, left anterior segment vein and upper lingual segment vein ; ② In the level of the pulmonary artery branches, the left and right upper pulmonary veins can be seen under the right pulmonary artery, and the posterior segment venous, anterior segment vein and lingual vein appear in the left upper pulmonary veins in 11 cases (55%); , The left and right lobes of the lungs and their branches showed a clear, below the trachea twigs can be seen left and right lower pulmonary veins merge into the left atrium; ④ middle bronchial plane, you can see the lungs of the lower lobes of both lungs bronchial, pulmonary and pulmonary vein origin ; ⑤ thoracic aorta, mainly for the upper and lower posterior pulmonary tuberculosis and blood vessels; ⑥ spinal level, the lower lobes of the lungs mainly for the upper, lateral and posterior segment of the bottom of the bronchus and blood vessels. CONCLUSIONS: By carefully identifying the bronchus, pulmonary arteries and pulmonary veins of the lung segment, the segment of the lung can be precisely segmented over the coronal section.