Remy J, Remy-Jardin M, Artaud D, Fribourg M
Department of Radiology, Hospital Calmette, Cedex, France.
Eur Radiol. 1998;8(3):335-51. doi: 10.1007/s003300050391.
The purpose of this review is to capture the current state-of-the art of the technical aspects of multiplanar and three-dimensional (3D) images and their thoracic applications. Planimetric and volumetric analysis resulting from volumetric data acquisitions obviates the limitations of segmented transverse images. Among the 3D reconstruction techniques currently available, the most recently introduced technique, i. e., volume rendering, has to be evaluated in comparison with 3D shaded surface display and maximum or minimum intensity projection. Slabs are useful in detecting and localizing micronodular or microtubular patterns and in analyzing mild forms of uneven attenuation of the lungs. Three-dimensional angiography is helpful in the pretherapeutic evaluation and posttreatment follow-up of pulmonary arteriovenous malformations, in the comprehension of the postoperative reorientation of the pulmonary vessels, in the surgical planning of pulmonary tumors, and in the diagnosis of marginated thrombi. The systemic supply to the lung and superior vena cava syndromes are also relevant to these techniques. In acquired or congenital tracheobronchial diseases including stenosis, extraluminal air and complex airway anatomy, multiplanar and 3D reformations have a complementary role to both transaxial images and endoscopy. New developments are also expected in various topics such as 3D conformal radiation therapy, planning of intraluminal bronchoscopic therapy, virtual endoscopy, and functional imaging of the bronchial tree. Miscellaneous clinical applications are promising in the analysis of diaphragmatic morphology and pathophysiology, in the volumetric quantification of the lung parenchyma, and in the vascular components of the thoracic outlet syndromes.
本综述的目的是阐述多平面和三维（3D）图像技术方面的当前技术水平及其在胸部的应用。容积数据采集产生的平面测量和容积分析消除了分割横断图像的局限性。在目前可用的3D重建技术中，最新引入的技术，即容积再现，必须与3D阴影表面显示和最大或最小强度投影进行比较评估。层面在检测和定位微结节或微管状模式以及分析肺部轻度不均匀衰减形式方面很有用。三维血管造影有助于肺动静脉畸形的治疗前评估和治疗后随访，有助于理解肺血管术后的重新定位，有助于肺部肿瘤的手术规划，以及有助于诊断边缘性血栓。肺的体循环供血和上腔静脉综合征也与这些技术相关。在包括狭窄、管腔外气体和复杂气道解剖结构在内的后天性或先天性气管支气管疾病中，多平面和3D重建对横断图像和内镜检查都具有补充作用。在诸如3D适形放射治疗、腔内支气管镜治疗规划、虚拟内镜检查以及支气管树功能成像等各种主题方面也有望取得新进展。在膈肌形态和病理生理学分析、肺实质容积定量以及胸廓出口综合征的血管成分分析方面，各种临床应用前景广阔。
