Perhomaa M, Lähde S, Rossi O, Suramo I
Department of Diagnostic Radiology, University Central Hospital, Oulu, Finland.
Acta Radiol. 1997 Jan;38(1):83-91. doi: 10.1080/02841859709171247.
To establish a protocol for and to assess the value of helical CT in the imaging of the bronchial tree.
Noncontrast helical CT was performed in 30 patients undergoing fiberoptic bronchoscopy for different reasons. Different protocols were compared; they included overlapping 10 mm, 5 mm, or 3 mm slices and non-tilted, cephalad or caudad tilted images. Ordinary cross-sectional and multiplanar 2D reformats were applied for visualization of the bronchial branches. The effect of increasing the helical pitch was tested in one patient.
A total of 92.1-100% of the segmental bronchi present in the helical acquisitions were identified by the different protocols. The collimation had no significant impact on the identification of the bronchial branches, but utilization of 3-mm overlapping slices made it easier to distinguish the nearby branches and provided better longitudinal visualization of the bronchi in 2D reformats. The tilted scans illustrated the disadvantage of not covering all segmental bronchi in one breath-hold. An increase of the pitch from 1 to 1.5 did not cause noticeable blurring of the images. CT and bronchoscopic findings correlated well in the area accessible to bronchoscopy, but CT detected 5 additional pathological lesions (including 2 cancers) in the peripheral lung.
Helical CT supplemented with bronchography-like 2D reformats provides an effective method complementary to bronchoscopy in the examination of the bronchial tree.
建立一种螺旋CT支气管树成像方案并评估其价值。
对30例因不同原因接受纤维支气管镜检查的患者进行非增强螺旋CT扫描。比较了不同方案，包括层厚为10mm、5mm或3mm的重叠扫描以及无倾斜、头侧倾斜或尾侧倾斜扫描。应用普通横断面和多平面二维重组图像来显示支气管分支。对1例患者测试了增加螺旋螺距的效果。
不同方案可识别螺旋扫描中92.1% - 100%的段支气管。准直对支气管分支的识别无显著影响，但采用3mm重叠层厚更易于区分相邻分支，并在二维重组图像中提供更好的支气管纵向显示。倾斜扫描显示了在一次屏气中无法覆盖所有段支气管的缺点。螺距从1增加到1.5并未导致图像明显模糊。在支气管镜可及区域，CT与支气管镜检查结果相关性良好，但CT在外周肺中额外检测到5处病理病变（包括2处癌症）。
螺旋CT辅以类似支气管造影的二维重组图像为支气管树检查提供了一种有效的方法，可作为支气管镜检查的补充。
