本文選題：肺隔離癥 + MSCT增強(qiáng)　； 參考：《大連醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：探討MSCT胸部增強(qiáng)與三維重建血管成像在肺隔離癥診斷中的價(jià)值，并對(duì)肺隔離癥的分型進(jìn)行相關(guān)研究。 材料和方法：回顧性分析我院自2007年01月至2012年3月診斷肺隔離癥的病例18例，其中男性10例，女性8例，年齡16-74歲，平均年齡48歲�；颊呔驮\時(shí)咳嗽、咳痰伴胸痛6例；僅有咳嗽癥狀者3例；咯血3例（咯血量2-20ml）；咳嗽、咳痰、痰中帶血絲3例；咳嗽、咳痰、痰中帶血塊1例；門診常規(guī)體檢疑診并確診者2例。全部病例均應(yīng)用GELightspeed Qx/Plus16排螺旋CT行平掃與增強(qiáng)掃描，層厚5mm，螺距0.938:1，重建間隔1.25mm，應(yīng)用非離子型對(duì)比劑（優(yōu)維顯300mg/mL）100mL，以4mL/s流速?gòu)闹庹徐o脈注入，開(kāi)始注藥后延遲20s開(kāi)始掃描。在ADW4.2工作站應(yīng)用容積再現(xiàn)（VR）、多層面重組（MPR）及最大密度投影(MIP)等三維重建技術(shù)完成血管與病變的重建。 應(yīng)用SPSS11.5統(tǒng)計(jì)學(xué)軟件包進(jìn)行分析。PS按不同的診斷方式分為兩組，比較PS的異常供血?jiǎng)用}采用X2檢驗(yàn)分析；比較PS的分型，采用Fisher確切概率法分析。 結(jié)果：18例肺隔離癥患者中，，病灶位于左肺下葉17例、右肺下葉1例；三維重建血管成像技術(shù)檢出異常供血?jiǎng)用}中發(fā)自胸主動(dòng)脈16例、腹主動(dòng)脈1例、膈動(dòng)脈1例；肺隔離癥CT表現(xiàn)分型：囊性腫塊型4例，實(shí)性腫塊型6例，囊實(shí)混合腫塊型2例，局部肺葉內(nèi)增多、增粗、紊亂的血管結(jié)構(gòu)型6例；病灶內(nèi)伴有鈣化4例，余14例未見(jiàn)鈣化灶�；颊咝惺中g(shù)10例（葉內(nèi)型8例，葉外型2例），未行手術(shù)隨訪8例（分析診斷葉內(nèi)型6例，葉外型2例）。 MSCT胸部增強(qiáng)與三維重建血管成像和手術(shù)病理在診斷PS的異常供血?jiǎng)用}與分型上，兩組之間無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）。 結(jié)論：MSCT胸部增強(qiáng)與三維重建血管成像技術(shù)在肺隔離癥的診斷中具有重要的應(yīng)用價(jià)值，特別是VR重建技術(shù)，可以作為診斷肺隔離癥的金標(biāo)準(zhǔn)技術(shù)。
[Abstract]:Objective: to investigate the value of MSCT chest enhancement and three dimensional reconstruction angiography in the diagnosis of pulmonary sequestration, and to study the classification of pulmonary sequestration. Materials and methods: 18 cases of pulmonary sequestration diagnosed in our hospital from January 2007 to March 2012 were retrospectively analyzed, including 10 males and 8 females, aged 16-74 years with an average age of 48 years. There were 6 cases of cough, expectoration with chest pain, 3 cases of cough symptoms, 3 cases of hemoptysis (hemoptysis volume 2-20 ml), 3 cases of cough, expectoration and sputum with blood silk in phlegm, 1 case of cough, expectoration, and 1 case of blood clot in phlegm. 2 cases were confirmed by routine physical examination. All cases were scanned by GELightspeed Qx/Plus16 slice spiral CT with slice thickness of 5 mm, pitch of 0.938: 1, reconstruction interval of 1.25 mm, and Nonionic contrast agent (UVX 300mg / mL, 100mL) was injected from the median cubital vein at the flow rate of 4mL/s. The scan was started 20 s after injection. Three-dimensional reconstruction techniques such as volume reconstruction, multilayer recombination and maximum density projection were used to reconstruct blood vessels and lesions in ADW4.2 workstation. PS was divided into two groups according to different diagnostic methods by using SPSS11.5 statistical software package. The abnormal supply arteries of PS were analyzed by X2 test, and the classification of PS was analyzed by Fisher exact probability method. Results among 18 patients with pulmonary sequestration, 17 cases were located in the left lower lobe of lung and 1 case in the right lower lobe, 16 cases were from thoracic aorta, 1 case was abdominal aorta, and 1 case was phrenic artery. There were 4 cases of cystic mass type, 6 cases of solid mass type, 2 cases of cystic solid mass type, 6 cases of regional pulmonary lobe hyperplasia, thickening and disorder vascular structure type, 4 cases with calcification in the focus, and 14 cases without calcification. Operation was performed in 10 cases (8 cases of intra lobar type, 2 cases of extralobar type, 8 cases of non-operative follow-up) (6 cases of intralobar type and 2 cases of extralobar type) were analyzed. There was no significant difference between the two groups in the diagnosis of abnormal supply arteries and types of PS by MSCT chest enhancement, three-dimensional reconstruction angiography and surgery and pathology (P > 0.05). Conclusion MSCT chest enhancement and three-dimensional reconstruction angiography have important application value in the diagnosis of pulmonary sequestration, especially VR reconstruction technology, which can be used as the golden standard in the diagnosis of pulmonary sequestration.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R816.41

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