目的 探讨多层螺旋CT三维血管成像在肺隔离症诊断中的应用价值.方法 收集经手术及病理证实的9例肺隔离症患者的资料进行回顾性分析.所有检查采用GE公司的64排螺旋CT扫描机,先行CT平扫,再行双期增强扫描,将图像传输至工作站,进行MPR、MIP、SSD 及VR 重建.结果 9例肺隔离症均位于下叶后基底段,其中7例位于左下肺,2例位于右下肺.异常供血动脉8例来自于胸主动脉,1例来自于腹腔干.CT平扫主要表现为肺内囊肿、结节或肿块,局部可伴肺气肿征.增强扫描病变区血管影增多、增粗,呈条状或结节状血管强化影.CT血管成像显示病变由异常体动脉供血.采用MPR和MIP可显示供血动脉整体形态及肺实质的病灶.SSD及VR能显示供血动脉的起源与行程及引流静脉.结论 多层螺旋CT增强及三维重建可以清晰显示肺部病变及异常供血和引流血管情况,是诊断肺隔离症最理想非创性检查方法.%Objective To explore the application value of multi-slice spiral CT angiography in the diagnosis of pulmonary se-questration. Methods We collected 9 cases of pulmonary sequestration confirmed by surgery and pathology and retrospectively analyzed. All were examined by 64 slice spiral GE scanner,CT. First CT plain scan,and then double phase enhanced scan,the image will be transferred to the workstation,MPR,MIP,SSD and VR reconstruction. Results 9 cases of pulmonary sequestra-tion were located in the posterior basal segment of lower lobe,Of which 7 cases were located in the left lower lung,2 cases were located in the right lower lung. Abnormal blood supply artery in 8 cases was from thoracic aorta,1 case was from celiac trunk. CT scan was mainly manifested as pulmonary cyst,nodule or mass. Enhancement of blood vessel shadow in the lesion area was en-hanced,and a strip or nodular enhancement can also be seen. CT angiography showed that the lesion was supplied by the abnor-mal body artery. MPR and MIP can be used to show the overall shape of the feeding artery and the lesion of the lung parenchyma. SSD and VR can show the origin and stroke of the feeding artery and the venous drainage. Conclusion Enhanced multislice spi-ral CT and 3D reconstruction can clearly display the pulmonary lesions and abnormal blood supply and drainage vessels,which is the diagnosis of pulmonary sequestration the best noninvasive inspection method.
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