双肺下叶静脉解剖分型MSCT评价及临床应用探讨

doi:10.13418/j.issn.1001-165x.2025.1.06

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中国临床解剖学杂志 ›› 2025, Vol. 43 ›› Issue (1) : 31-39. DOI: 10.13418/j.issn.1001-165x.2025.1.06

断层影像解剖

双肺下叶静脉解剖分型MSCT评价及临床应用探讨

王娟¹，郭龙军¹，滕佳岐¹，陈玉昆¹, 贺文²*

作者信息 +

MSCT evaluation and clinical application in anatomic classification of bilateral inferior pulmonary veins

Wang Juan ¹, Guo Longjun ¹, Teng Jiaqi ¹, Chen Yukun ¹, He Wen ²*

Author information +

文章历史 +

摘要

目的应用多层螺旋CT(MSCT)对健康人双肺下叶肺静脉解剖及引流模式分型，阐述其特点，为解剖性肺段切除术靶静脉解剖分型提供帮助。方法收集200例肺部无异常胸部CT影像资料,通过VR重建获得静脉解剖及引流模式图，观察并统计各静脉分型出现率。结合重建5mm轴位MIP图，选择三个重点观察平面，辨识对应各分型。结果 V6根据干的数量分为两种类型：单干（88%）、双干（12%），单干为最常见的类型。此外， S6和S10之间存在独立节段S*，有独立的节段性支气管（B）和动脉（A）。双下肺基底静脉的特点是放射状排列。内侧基底段静脉（V7）大部分分支管径纤细。前基底节段、外侧基底节段和后基底节段静脉（V8，V9，V10）分支模式分为以下四种组合类型：V8+V9/V10型、V8/V9+V10型、V8+V9+V10/V10型、V8+V9/V9+V10型，各型占比率各有不同。结论肺静脉解剖分型及引流模式图可作为解剖识别常规手段,为肺段切除术前肺静脉精细解剖评价提供依据，本研究所获数据可作为3D-CT图像的补充,为肺段切除术靶静脉及支气管精细解剖了解提供帮助。

Abstract

Objective To study the anatomy and drainage pattern of pulmonary veins in the lower lobes of both lungs in healthy people by using multi-slice spiral CT (MSCT), and to elucidate its characteristics, so as to provide basis for the anatomical classification of target veins in anatomic segmental pneumonectomy. Methods The CT image data of 200 cases with normal lung were collected, and the venous anatomy and drainage pattern were obtained by VR reconstruction. The occurrence rate of venous classification was observed and counted. Combined with the reconstructed 5 mm axial MIP map, three key observation planes were selected to identify the corresponding subtypes. Results V6 could be divided into two types according to the number of stems: single trunk (88%), which was the most common type, and double trunk (12%). In addition, there was an independent segment S* between S6 and S10. There were independent segmental bronchi (B) and arteries (A). The bilateral inferior pulmonary basal veins were characterized by radial arrangement. Most of the branches of the medial basal segment vein (V7) were thin in diameter. The branching patterns of anterior basal segment, lateral basal segment and posterior basal segment veins (V8, V9, V10) could be divided into the following four types: V8+V9 / V10 type, V8 / V9+V10 type, V8+V9+V10 / V10 type, and V8+V9 / V9+V10 type, with different proportion in each type. Conclusions The anatomical classification and drainage pattern of pulmonary veins can be used as a routine means of anatomical recognition, which provides basis for the fine anatomical evaluation of pulmonary veins before segmentectomy. The data obtained in this study can be used as a supplement to 3D-CT images, which can help to understand the fine anatomy of target veins and bronchi after segmentectomy.

导出引用

王娟, 郭龙军, 滕佳岐, 陈玉昆, 贺文. 双肺下叶静脉解剖分型MSCT评价及临床应用探讨[J]. 中国临床解剖学杂志. 2025, 43(1): 31-39 https://doi.org/10.13418/j.issn.1001-165x.2025.1.06

Wang Juan, Guo Longjun, Teng Jiaqi, Chen Yukun, He Wen. MSCT evaluation and clinical application in anatomic classification of bilateral inferior pulmonary veins[J]. Chinese Journal of Clinical Anatomy. 2025, 43(1): 31-39 https://doi.org/10.13418/j.issn.1001-165x.2025.1.06

中图分类号： R814.42 R561

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