Berkmen T, Berkmen Y M, Austin J H
Department of Radiology, Columbia University, Columbia-Presbyterian Medical Center, New York, NY 10032-3784.
AJR Am J Roentgenol. 1994 Jun;162(6):1287-93. doi: 10.2214/ajr.162.6.8191982.
The purpose of this study was to assess CT and chest radiographic features of accessory fissures of the upper lobe of the left lung.
Eighteen accessory fissures of the upper lobe of the left lung were identified on CT scans of 17 adult patients. The collimation was 10 mm in 12 patients and 8 mm in five patients. Additional, thinner sections (1.5-5.0 mm) were available for 12 patients. The segments separated by each fissure were identified by means of the individual segmental bronchi and vessels. Available chest radiographs were correlated with CT studies in 12 patients.
The fissures separated the anterior segment of the left upper lobe from the superior segment of the lingula (left minor fissure) in 13 cases (72%), the superior from the inferior segment of the lingula in three cases (17%), and the apico-posterior from the anterior segment in two cases (11%). Ten (56%) of the 18 fissures could be seen only on thin sections. Eleven (61%) of the accessory fissures were incomplete. The fissures were classified into four types: convex laterally (n = 8), convex medially (n = 2), anteromedial (n = 5), and transverse (n = 3). On posteroanterior chest radiographs, the accessory fissure was evident in 10 (83%) of 12 patients. CT studies showed that nine of the 10 fissures seen on radiographs represented a left minor fissure, and the remaining fissure separated the two segments of the lingula.
Accessory fissures of the upper lobe of the left lung, as shown by CT, can separate any two contiguous segments, are frequently incomplete, and occur in four different configurations. The left minor fissure is the most common of these fissures and the most frequently seen on chest radiographs. The ability to recognize accessory fissures of the left upper lobe should help in the segmental and topographic localization of pulmonary lesions.
本研究旨在评估左肺上叶副裂的CT及胸部X线特征。
在17例成年患者的CT扫描中识别出18条左肺上叶副裂。12例患者的准直为10mm，5例患者为8mm。12例患者有额外的薄层扫描（1.5 - 5.0mm）。通过各段支气管和血管确定每条副裂所分隔的肺段。12例患者的胸部X线片与CT检查结果进行对照。
13例（72%）副裂将左肺上叶前段与舌叶上段（左小裂）分隔开，3例（17%）将舌叶上段与下段分隔开，2例（11%）将尖后段与前段分隔开。18条副裂中有10条（56%）仅在薄层扫描上可见。11条（61%）副裂不完整。副裂分为四种类型：外侧凸型（n = 8）、内侧凸型（n = 2）、前内侧型（n = 5）和横型（n = 3）。在后前位胸部X线片上，12例患者中有10例（83%）副裂清晰可见。CT检查显示，X线片上所见的10条副裂中有9条为左小裂，其余1条分隔舌叶的两个肺段。
CT显示，左肺上叶副裂可分隔任意两个相邻肺段，常不完整，有四种不同形态。左小裂是这些副裂中最常见的，也是胸部X线片上最常出现的。认识左肺上叶副裂有助于肺部病变的肺段及解剖定位。
