CT Study Of Lung Segment Anatomy And Its Clinical Value

Purpose: To build the fusion model of pulmonary vessels, bronchi and lung parenchyma processed with CT volume renderding(VR), and to evaluate its visualization capability of CT anatomy of pulmonary segment.Materials and Methods: One patient scanned by 64-slice CT on pulmonary arterial phase was studied, and the CT values were 525 Hu and 403 Hu on pulmonary arterial trunk and pulmonary vein, respectively. The bronchi, arteries and veins of pulmonary segments were reconstructed by VR in Work Station, and build the VR fusion model of vessels, bronchi and parenchyma of pulmonary segments. The pulmonary bronchi, arteries, veins and intersegmental septa were analyzed on submillimeter image, multiplanar reconstruction(MPR), VR image and VR fusion image.Results: ①. Segmental and subsegmental bronchi were visualized clearly, and the level 7 bronchi could be shown. ②. The segmental arteries of both lung could be shown and traced. ③. 50%(8/16) of the segmental veins run in pulmonary intersegmental septa, and 50%(8/16) of the segmental veins run in pulmonary parenchyma. ④. 22%(4/18) of the pulmonary intersegmental septa could be located directed by " area without lung marking+ intersegmental vein+highdensity line". 78%(14/18) of the pulmonary intersegmental septa should be located by pulmonary artery tree.Conclusion: CT anatomic structure of pulmonary segment could be visualized clearly on the VR fusion model of vessels, bronchi and parenchyma of pulmonary segments with MPR.Purpose: To investigate 30 cases of pulmonary artery, pulmonary vein, bronchial anatomy and variation, and explore its value in lung segmentectomy.Materials and Methods: 30 patients were enrolled in our study. We perform pulmonary VR on GE’s ADW4.4 workstation.Observed bronchus, pulmonary artery, pulmonary vein anatomy and its variation combination with sub-millimeter thin multi-planar image reconstruction technique.Result: ①. 27 cases of segmental bronchial came out separately. Segmental bronchi have the same trunk in 3 cases, and both apical segments and posterior segment bronchi were in same trunk(B1+2). ②. 54 case of right upper lobe pulmonary on three levels were shown, including in 5 cases 1 branch, 23 cases 2 branches, three branches in 1 case, four branches in 1 case; All the apical right upper lobe pulmonary artery came out primarily from the right pulmonary artery branch. ③ 39 of intersegmental vein were shown, and then the two segmental veins run into pulmonary intersegmental septa. 59 of intersegmental vein run in the lung segments directly. ④. there were 41 cases with two pulmonary veins draining, accounted for 46%(41/90). there were 49 cases with 1 pulmonary vein draining, accounted for 54%; which pulmonary segment venous drainage originated from the segmental vein were 18, accounted for 37%(18/49).Conclusion: Three-dimensional CT can show bronchus, pulmonary artery and pulmonary vein of CT anatomy and its variants clearly, and provide anatomical information of segmentectomy for the thoracic surgeon...