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右肋间支气管动脉多层螺旋CT影像解剖学研究 预览 被引量:4

Radiological anatomy of the right intercostal bronchial arteries under Multi-slice spiral CT angiography
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摘要 目的:利用多层螺旋CT血管造影(MSCTA)研究右肋间支气管动脉三维影像解剖特征,为临床支气管动脉栓塞治疗咯血,支气管动脉灌注化疗或灌注栓塞治疗中晚期肺癌提供解剖学依据。方法:对132例行胸部增强扫描,CTA清晰显示右支气管动脉的病例,采用容积显示(VR)、多平面重建(MPR)、最大密度投影(MIP)等进行三维重建,观察和分析肋间-支气管动脉干、右支气管动脉及肋间后动脉的相关解剖学特征。结果:68.9%(91例)右支气管动脉源自肋间后动脉,除1例与左侧第4肋间后动脉共干外,其余90例均与右侧肋间后动脉共干;右支气管动脉与肋间后动脉的共干类型有8种,最为常见的是与右侧第3肋间后动脉共干;共干起点多平对T5~T6椎体,除1例起源于主动脉弓外,其余90例均起源于降主动脉右侧壁;以降主动脉血流方向为顺行方向,肋间-支气管动脉干与降主动脉间平均逆行角度为102.6°;共干起点与支气管动脉起点间距为0.3~4.2cm不等,平均间距为2.3cm;右支气管动脉从肋间一支气管动脉干上发出方式多样,与远侧肋间后动脉可呈锐角、直角,甚至钝角,平均夹角为90.7°;所有肋间支气管动脉开口对应于T4~T6椎体范围,且多位于椎体正前方,向两侧均不超过肋骨小头,其开口与肋骨小头平均间距为4.1cm。结论:右肋间支气管动脉解剖学特征复杂,CTA三维成像能予以较好评价。 Objective: To evaluate 3-dimensional imaging features of the right intercostal bronchial arteries using multi-slice CT angiography (MSCTA) and provide anatomic data for clinic treatment of hemoptysis and lung cancers adopting bronchial arterial embolism. Methods: After receiving enhanced chest CT scan (CTA), the CTA data of those displayed right bronchial arteries clearly from 132 patients were processed at the workstation. 3-dimensional reconstruction of the arteries was performed according to different parameters, including multi-planar reformat (MPR), maximum intensity projection (MIP) and volume rendering (VR). Results: The right bronchial arteries of 91 cases (68.9%) originated from the posterior intercostal arteries, and mainly arised from the right posterior intercostal arteries, except one case whose artery arised from the fourth left posterior intercostal artery. For common trunks of the right bronchial artery and the posterior intercostal artery, 8 types could be identified, with the commonest type of the right bronchial artery origining from the third right posterior intercostal artery. The origin points of common trunks were mainly at the level of T5-T6, and mostly arised from the right wall of the descending aorta. Taking the direction of the descending aortic flow as the forward direction, the average inverse angle of the intercostal-bronchial artery trunks and the descending aorta was about 102.6°. The distance between the starting points of common trunks and the intercostal bronchial arteries was 0.3-4.2 cm, averagely 2.3 cm. The styles that the right bronchial arteries arised from the intercostal-bronchial arteries trunks were variable, including acute, right or even obtuse angles between the right bronchial arteries and the distal posterior intercostal arteries, with the average angle of 90.7°. All the beginnings of the intercostal bronchial arteries were at the level of T4-T6, located at the anterior aspect of vertebral body, and limited within bilateral capitulu
作者 李琦 吴景全 罗天友 黄兴涛 李信友 刘历 LI Qi, WU Jing-quan, LUO Tian-you,et al.( Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China)
出处 《中国临床解剖学杂志》 CSCD 北大核心 2008年第3期 283-286,共4页 Chinese Journal of Clinical Anatomy
关键词 右肋间支气管动脉 CT血管造影 解剖学 right intercostal bronchial artery CT angiography anatomy
作者简介 李琦,女,重庆人,在读硕士,主要从事医学影像学研究,Tel:023—89014385,Email:zhuoshui@sina.com 【通讯作者】吴景全,主任医师,硕士生导师,Tel:023-68812088
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