基于活体CT数据的成人右肺动脉分支形式及其临床意义

刘海蓝 梅艺璇 张翼 柳澄 刘树伟

解剖学报 ›› 2023, Vol. 54 ›› Issue (4) : 453-459.

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解剖学报 ›› 2023, Vol. 54 ›› Issue (4) : 453-459. DOI: 10.16098/j.issn.0529-1356.2023.04.011
解剖学

基于活体CT数据的成人右肺动脉分支形式及其临床意义

  • 刘海蓝1 梅艺璇1 张翼2 柳澄2 刘树伟1* 
作者信息 +

Classification and clinical significance of the branching patterns of the right pulmonary arteries based on the intravital CT data

  • LIU  Hai-lan1  MEI  Yi-xuan1  ZHANG  Yi2  LIU  Cheng2  LIU  Shu-wei1*
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文章历史 +

摘要

目的 对三维重建下的右叶肺动脉的分支类型进行追踪与统计,并探讨其临床意义。  方法  应用血管容积重建后处理技术对350例肺血管造影图像进行处理,并根据血管三维显示图像对肺动脉分支形式进行分类与统计。   结果  右肺上叶肺动脉分成6种类型,分别为单支前干+后升支型、单支前干型、单只前干+前升支+后升支型、单支前干+前升支型、上前干+下前干型、上前干+下前干+后升支型;中叶分为单干和双干2种类型;下叶的上段动脉分为单干、双干、3干 3种类型,基底段动脉分为内侧(基)底段动脉+前(基)底段动脉+外后(基)底段动脉、内前(基)底段动脉+外后(基)底段动脉型以及内侧(基)底段动脉+前外侧(基)底段动脉+后段(基)底段动脉型。总之,右肺上叶、中叶和下叶占据最多的类型分别是单前干+后升支(56.6%)、单干的中叶动脉(57.4%)和单干的上段动脉+内侧底段动脉+前底段动脉+外后底段动脉共干(32.5%)。  结论  通过大数据下肺血管造影三维重建结果将右肺动脉分支类型进行了明确地分类与统计,有助于肺部肿瘤的外科精准治疗。

Abstract

Objective  To track and make statistics of the right pulmonary arteries’ branches and to study the clinical significance.   Methods  Technologies of vascular volume rending were used to analyze the 350 CT pulmonary angiography images. And the three-dimensional display was used to classify the pulmonary arteries.    Results  According to the 350 reconstructed result, the right upper pulmonary arteries were divided into 6 types: anterior trunk+ post ascending artery, anterior trunk, anterior trunk+ anterior ascending artery+ post ascending artery, superior anterior trunk + inferior anterior trunk+ post ascending artery, anterior trunk+ anterior ascending artery and superior anterior trunk+ inferior anterior trunk. The right middle pulmonary arteries were divided into 2 types: one branch  and two branches. As for the right lower pulmonary arteries, the apical arteries were divided into 3 types: one branch, two branches and three branches. The basal segmental arteries were divided into 3 types: medial basal segmentalartery+anterior basal segmental artery+lateroposterior basal segmental artery, medioanterior basal segmental artery+lateroposterior basal segmental artery and medial basal segmental artery+anterior and lateral basal segmental artery+posterior basal segmental artery. To be specific, anterior trunk+ post ascending artery type (56.6%) occupied the most in the right upper pulmonary arteries. The majority type of right middle pulmonary artery was one branch(57.4%). In the right lower pulmonary arteries, apical artery of the lower lobe (one branch)+medial basal segmental artery+anterior basal segmental artery+lateroposterior basal segmental artery type(32.5%)was most common.    Conclusion  The classification of the right pulmonary arteries based on the three dimensional reconstruction of CT pulmonary angiography is of significant to surgical precision therapy of lung tumor.

关键词

肺动脉 / 肺动脉造影 / 容积重建 / 解剖学 /

Key words

Pulmonary artery / CT pulmonary angiography / Volume rending / Anatomy / Human

引用本文

导出引用
刘海蓝 梅艺璇 张翼 柳澄 刘树伟. 基于活体CT数据的成人右肺动脉分支形式及其临床意义[J]. 解剖学报. 2023, 54(4): 453-459 https://doi.org/10.16098/j.issn.0529-1356.2023.04.011
LIU Hai-lan MEI Yi-xuan ZHANG Yi LIU Cheng LIU Shu-wei. Classification and clinical significance of the branching patterns of the right pulmonary arteries based on the intravital CT data[J]. Acta Anatomica Sinica. 2023, 54(4): 453-459 https://doi.org/10.16098/j.issn.0529-1356.2023.04.011
中图分类号: R813    R322.3   

参考文献

[1]Sieveking EH. On the diagnostic value of murmur in the pulmonary artery[J].  Lancet,1860, 75(1902): 135-137. 
[2]Boyden EA. An analysis of variations in the bronchial pattern of the right upper lobe of 50 lungs[J]. Anat Rec,1947,97(3): 381. 
[3]Burakovskiǐ VI,Bukharin VA,Podzolkov VI,et al. Origin of the aorta and the pulmonary artery from the right -ventricle[J].Grud Serdechnososudistaia khir,1990,(1):4-10. 
[4]Chen EY, He GCh, Liu ZhJ, et al. An analysis of the variations of the Broncho-vascular patterns of the left upper lobe in fifty Chinese lungs [J]. Acta Anatomica Sinica, 1960, 5(1): 30-50.(in Chinese)

陈尔瑜,何光篪,刘正津,等.中国人肺的支气管和血管——一、右肺上叶的支气管和血管[J]. 解剖学报,1960, 5(1): 30-50. 

[5]Zhong ShZh, He GCh, Chen EY, et al. An analysis of the variations of the broncho-vascular patterns of the left upper lobe in fifty Chinese lungs [J]. Acta Anatomica Sinica, 1963, 6(2): 183-199.(in Chinese)

钟世镇,何光篪,陈尔瑜,等.中国人肺的支气管和血管——四、左肺上叶的支气管和血管[J]. 解剖学报,1963, 6(2): 183-199. 
[6]Liu ShW. Sectional Anatomy[M].Beijing: Higher Education Press, 2017:166-168. (in Chinese)
刘树伟. 断层解剖学[M]. 北京:高等教育出版社,2017:166-168. 
[7]Mathes ME, Reichert FL, Holman E. An experimental method for the radiographic demonstration of the bronchial and pulmonary arteries[J]. Exp Biol Med, 1930, 27(4):278-282. 
[8]Remy-Jardin M,Remy J,Artaud D,et al. Peripheral pulmonary arteries: optimization of the spiral CT acquisition protocol[J]. Radiology,1997,204(1):157-163. 
[9]Matsumoto K,Yamasaki N,Tsuchiy T,et al. Three-dimensional computed tomography for a mediastinal basal pulmonary artery[J]. Ann Thorac Surg,2012,94(5): e115-116. 
[10]Nagashima T,Shimizu K,Ohtaki Y,et al. Analysis of variation in bronchovascular pattern of the right middle and lower lobes of the lung using three-dimensional CT angiography and bronchography[J]. Gen Thorac Cardiovasc Surg, 2017,65(6): 343-349. 
[11]Zhang GZh. The importance of CT imaging in identifying early lung cancer[J]. Chongqing Medicine, 2017, 46(19): 2593-2598. (in Chinese)
张国桢. 论CT影像在识别早期肺癌中的重要性[J]. 重庆医学,2017,46(19): 2593-2598. 
[12]Ding JA. Pulmonary Surgery [M]. Beijing: People’s Health Publishing House, 2011:82-83. (in Chinese)
丁嘉安. 肺外科学[M]. 北京:人民卫生出版社,2011:82-83. 
[13]Fourdrain A,De Dominicis F,Blanchard C,et al. Three-dimensional CT angiography of anatomic variations in the pulmonary arterial tree[J]. Surg Radiol Anat,2018,40(1): 45-53. 
[14]Yan Sh, Wu N, Wang X, et al. Anatomical branches of right upper lobe pulmonary arteries in Chinese patients[J].Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(7): 567-571. (in Chinese)
阎石,吴楠,王兴,等. 右肺上叶肺动脉分支特点[J]. 中国胸心血管外科临床杂志, 2018, 25(7): 567-571. 
[15]Zhang M, Wang T, Zhao XY, et al. The application of multi-slice spiral CT angiography in the anatomy of the right upper artery [J]. Journal of Medical Imaging, 2016,26(3): 435-438. (in Chinese)
张苗,王涛,赵新亚,等. 多层螺旋CT血管造影在右肺上叶动脉解剖中的应用[J]. 医学影像学杂志,2016,26(3): 435-438. 
[16]Nagashima T,Shimizu K,Ohtaki Y,et al. An analysis of variations in the bronchovascular pattern of the right upper lobe using three-dimensional CT angiography and bronchography[J]. Gen Thorac Cardiovasc Surg, 2015,63(6): 354-360. 
[17]He GCh, Liu ZhJ, Zhang SZh, et al. An analysis of the variations of the Broncho-vascular patterns of the left upper lobe in fifty Chinese lungs [J]. Acta Anatomica Sinica, 1963,6(2): 163-182. (in Chinese)
何光篪,刘正津,张素贞,等. 中国人肺的支气管和血管——三、右肺下叶的支气管和血管[J]. 解剖学报,1963,6(2): 163-182. 
[18]Dai HB, Wang GB, Wang JB. Broncho-vascular patterns of the middle lobe of the right lung[J]. Acta Anatomica Sinica, 1958,3(1): 22-40. (in Chinese)戴和璧,王根本,王健民. 右肺中叶支气管及血管[J]. 解剖学报,1958,3(1): 22-40. 
[19]Jiang JY. Surgical Anatomy of the Bronchopulmonary Segment[M].Shanghai: Shanghai Science and Technology Publishing House, 1960:60-62. (in Chinese)
江家元. 支气管肺段外科解剖学[M].上海:上海科技出版社,1960:60-62. 

[20]Ferry Jr RM,Boyden EA. Variations in the bronchovascular patterns of the right lower lobe of fifty lungs[J]. J Thorac Surg,1951,22(2):188-201. 

[21]Ojanguren A,Recuero JL,Pardina M,et al. Three dimensional computed tomography for preoperative assessment of the pulmonary artery in patients undergoing endoscopic lobectomy or segmentectomy[J]. Cir Esp,2017,95(2):102-108. 

[22]Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial[J]. J Thorac Cardiovasc Surg, 2019, 158(3):895-907. 
[23]Chen L, Wu WB. The main technical points of thoracoscopic anatomical lung segment resection [J]. Chinese Journal of Lung Cancer, 2016,19(6):377-381. (in Chinese)
陈亮,吴卫兵.胸腔镜解剖性肺段切除术技术要点[J].中国肺癌杂志,2016,19(6):377-381. 
[24]Nakazawa S, Shimizu K, Kawatani N, et al. Right upper lobe segmentectomy guided by simplified anatomic models[J]. JTCVS Tech, 2020, 4:288-297. 
[25]Kim NH, Delcroix M, Jais X, et al. Chronic thromboembolic pulmonary hypertension[J]. Eur Respir J, 2019, 53(1):1801915. 
[26]Mullin CJ, Klinger JR. Chronic thromboembolic pulmonary hypertension[J]. Heart Fail Clin, 2018,14(3):339-351. 
[27]Mahmud E, Madani MM, Kim NH, et al. Chronic thromboembolic pulmonary hypertension: evolving therapeutic approaches for operable and inoperable disease[J]. J Am Coll Cardiol, 2018, 71(21): 2468-2486. 

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