Department of Thoracic Surgery, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Radiology, Xinghai Hospital of Suzhou Industry ParkSuzhou, Suzhou, Jiangsu, China.
Thorac Cardiovasc Surg. 2024 Oct;72(7):557-567. doi: 10.1055/s-0044-1786195. Epub 2024 May 2.
Preoperative evaluation of pulmonary vascular and tracheal routes and variations is of great importance to the surgeon. Three-dimensional computed tomography bronchography and angiography (3D-CTBA) has evolved in recent years with the optimization of 3D reconstruction techniques and artificial intelligence. We aim to apply CT angiography and Exoview 3D reconstruction technology to assess patients' pulmonary arterial tree and its anatomical variants and to try to summarize a set of anatomical typing of the pulmonary arterial tree that is relatively easy and conducive to promoting teaching based on surgical habits of lobectomy.
A total of 358 patients hospitalized in the Department of Thoracic Surgery of the First Affiliated Hospital of Soochow University between July 2020 and August 2021 were included in this study. We carefully analyzed the site of emanation, alignment, and number of branches of the pulmonary artery according to a uniform classification method in conjunction with the two-dimensional CT images and transformed them into 3D reconstruction models.
Different types of pulmonary artery were observed in 358 cases. We evaluated the complete pulmonary artery tree and counted the number and frequency of major arteries of the pulmonary based on the surgical habits of anatomical lobectomy.
The 3D-CTBA technique enables us to adequately assess the anatomy of the pulmonary arteries. Moreover, we provide a practical classification scheme of pulmonary arterial anatomical patterns based on lobectomy and 3D-CTBA. Our data can be used by clinicians in the teaching of pulmonary artery anatomy and the preoperative preparation for anatomical lobectomy.
术前评估肺血管和气管通路及变异对外科医生非常重要。近年来，随着三维重建技术和人工智能的优化，三维计算机断层支气管血管造影（3D-CTBA）技术得到了发展。我们旨在应用 CT 血管造影和 Exoview 3D 重建技术评估患者的肺动脉树及其解剖变异，并尝试根据肺叶切除术的手术习惯，总结一套相对简单且有利于教学推广的肺动脉树解剖分型。
本研究共纳入 2020 年 7 月至 2021 年 8 月在苏州大学第一附属医院胸外科住院的 358 例患者。我们根据统一的分类方法，结合二维 CT 图像仔细分析肺动脉的分支位置、排列和数量，并将其转化为 3D 重建模型。
在 358 例患者中观察到不同类型的肺动脉。我们根据肺叶切除术的解剖习惯评估了完整的肺动脉树，并对主要肺动脉的数量和频率进行了计数。
3D-CTBA 技术使我们能够充分评估肺动脉的解剖结构。此外，我们基于肺叶切除术和 3D-CTBA 提供了一种实用的肺动脉解剖模式分类方案。我们的数据可用于临床医生进行肺动脉解剖教学和解剖性肺叶切除术的术前准备。
