肺动脉三维计算机断层扫描后的肺叶切除术
Lobectomy after three-dimensional computed tomography of the pulmonary artery.
作者信息
Simoglou Christos, Tsolakis Nikolaos
机构信息
Cardiothoracic Department, Medical University of Alexandroupolis, Greece
Cardiothoracic Department, St. Luke's Hospital, Thessaloniki, Greece.
出版信息
Asian Cardiovasc Thorac Ann. 2014 Nov;22(9):1080-3. doi: 10.1177/0218492314530976. Epub 2014 Apr 2.
AIM
Our aim was to evaluate the efficacy of 3-dimensional imaging using multidetector row helical computed tomography for preoperative assessment of the branching pattern of the pulmonary artery before complete video-assisted thoracoscopic lobectomy for lung cancer.
METHODS
Forty-nine consecutive patients with clinical stage I lung cancer scheduled for complete video-assisted thoracoscopic lobectomy were evaluated for pulmonary artery branching patterns on 16-channel multidetector row helical computed tomography. Intraoperative finding were compared with the 3-dimensional computed tomography angiography.
RESULTS
According to the intraoperative findings, 95.2% (139/146) of pulmonary artery branches were precisely identified on preoperative computed tomography angiography. All of the 7 undetected branches were less than 2 mm in diameter. No patient needed conversion to an open thoracotomy because of intraoperative bleeding.
CONCLUSION
Three-dimensional computed tomography angiography clearly revealed individual anatomies of the pulmonary artery and could play an important role in safely facilitating complete video-assisted thoracoscopic lobectomy. However, we were unable to detect several thin branches with this technique.
目的
我们的目的是评估在肺癌完全电视辅助胸腔镜肺叶切除术之前，使用多排螺旋计算机断层扫描进行三维成像对肺动脉分支模式进行术前评估的有效性。
方法
对连续49例计划进行完全电视辅助胸腔镜肺叶切除术的临床I期肺癌患者，采用16排多排螺旋计算机断层扫描评估肺动脉分支模式。将术中发现与三维计算机断层扫描血管造影结果进行比较。
结果
根据术中发现，术前计算机断层扫描血管造影能准确识别95.2%（139/146）的肺动脉分支。所有7条未检测到的分支直径均小于2毫米。没有患者因术中出血而需要转为开胸手术。
结论
三维计算机断层扫描血管造影能清晰显示肺动脉的个体解剖结构，在安全实施完全电视辅助胸腔镜肺叶切除术中可发挥重要作用。然而，我们用这种技术无法检测到几条细分支。
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