Anatomical observation of pulmonary sequestration based on dual-source CT enhanced scanning combined with cinematic rendering technology

doi:10.13418/j.issn.1001-165x.2025.6.02

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Chinese Journal of Clinical Anatomy ›› 2025, Vol. 43 ›› Issue (6) : 634-639. DOI: 10.13418/j.issn.1001-165x.2025.6.02

Anatomical observation of pulmonary sequestration based on dual-source CT enhanced scanning combined with cinematic rendering technology

He Xiaoning, Shan Yuqing, Xiao Juan, Mu Naiwen, Wang Li, Zheng Chao, Pan Yuefeng, Wang Chao*

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Abstract

Objective To explore the diagnostic value of dual-source enhanced CT scanning combined with cinematic rendering (CR) in pulmonary sequestration (PS), and to summarize and analyze the anatomical characteristics of PS. Methods Imaging data of 50 patients diagnosed with PS in Rizhao People's Hospital were retrospectively analyzed, and the maximal intensity projection (MIP) image and CR image were reconstructed. The type, location, morphological density, complications, blood supply vessels and drainage vessels of PS were observed, and the correlation between the diameter of blood supply vessels and the lesion volume was analyzed. Results The anatomical information of all 50 cases of PS could be clearly displayed, including 34 cases (68%) of intralobar sequestration (ILS) and 16 cases (32%) of extralobar sequestration (ELS). 35 cases (70%) were located in the lower lobe of the left lung (ILS 25, ELS 10), 14 cases (28%) in the lower lobe of the right lung (ILS 8, ELS 6), and 1 case (ILS) in the lower lobe of both lungs. There was no significant difference in PS distribution between the two types (P>0.05). PS was mainly cystic in 13 cases (26%) (ILS), mixed cystic and solid in 6 cases (12%) (ILS) and solid in 31 cases (62%) (ILS 15, ELS 16). There were 34 cases with complications (68%)(ILS 32, ELS 2). There were statistically significant differences between the two types of PS (P<0.05). The mean diameter of supplying blood vessels in thoracic aorta and abdominal aorta was (5.99±2.15) mm and (4.22±0.82) mm, respectively. The mean volume of PS supplied by the thoracic aorta was (82.24±31.61) cm3, and the mean volume of PS supplied by the abdominal aorta was (106.58±36.92) cm3. The differences were statistically significant (P<0.05). There was a significantly positive correlation between PS volume and the diameter of intraclobular type of thoracic aorta. Conclusions There are differences in the anatomical features and imaging findings of PS in different types and blood supply sources. Dual-source enhanced CT scanning combined with CR technology can provide realistic and three-dimensional visualization images, and clearly show the vascular and pulmonary anatomic features of PS, which can provide help for clinical diagnosis and treatment.

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Pulmonary sequestration / / / Computed tomography / / / Enhancement scan / / / Cinematic rendering / / / Anatomy

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He Xiaoning, Shan Yuqing, Xiao Juan, Mu Naiwen, Wang Li, Zheng Chao, Pan Yuefeng, Wang Chao. Anatomical observation of pulmonary sequestration based on dual-source CT enhanced scanning combined with cinematic rendering technology[J]. Chinese Journal of Clinical Anatomy. 2025, 43(6): 634-639 https://doi.org/10.13418/j.issn.1001-165x.2025.6.02

References

[1] Landing BH, Dixon LG. Congenital malformations and genetic disorders of the respiratory tract (larynx, trachea, bronchi, and lungs) [J]. Am Rev Respir Dis, 1979, 120(1):151-185. DOI: 10.1164/arrd. 1979.120.1.151.
[2] Mendeloff EN. Sequestrations, congenital cystic adenomatoid malform ations, and congenital lobar emphysema[J]. Semin Thorac Cardiovasc Surg, 2004,16(3): 209-214. DOI: 10.1053/j.semtcvs. 2004. 08.007.
[3] 朱晓龙, 刘庆啸, 邹殿俊, 等. 肺隔离症术前320排容积CT增强与术后病理对比分析[J]. 中国临床医生杂志, 2020, 48(7): 832-834. DOI: 10.3969/j.issn.2095-8552.2020.07.024.
Zhu XL, Liu QX, Zou DJ, et al. Comparative analysis of preoperative 320-slice volume CT enhancement and postoperative pathology in pulmonary sequestration[J]. Chinese Journal for Clinicians, 2020, 48(7): 832-834. DOI: 10.3969/j.issn.2095-8552.2020.07.024.
[4] 叶茜, 彭洋, 唐广磊, 等. Poland综合征多层螺旋CT影像解剖学分析及鉴别[J]. 中国临床解剖学杂志, 2023, 41(5): 522-526. DOI: 10.13418/j.issn.1001-165x.2023.5.04.
Ye X, Peng Y, Tang GL, et al. Anatomical analysis and differential diagnosis of Poland syndrome by multi-slice spiral CT[J]. Chin J Clin Anat, 2023, 41(5): 522-526. DOI: 10.13418/j.issn.1001-165x.2023.5.04.
[5] 王婵, 沈长青, 闫建平. 肺隔离征多层螺旋CT增强扫描影像学特点及病理特征分析[J]. 中国CT和MRI杂志, 2019, 17(8): 82-84. DOI: 10.3969/j.issn.1672-5131.2019.08.025.
Wang C, Shen CQ，Yan JP. Image characteristics of pulmonary sequestration enhanced by multi-slice spiral CT scan and its related pathological features [J]. Chinese Journal of CT and MRI, 2019, 17(8): 82-84. DOI: 10.3969/j.issn.1672-5131.2019.08.025.
[6] Hosokawa T, Tanami Y, Sato Y, et al. Imaging Diagnosis for Intradiaphragmatic Pulmonary Sequestration: A Pilot Study[J]. J Ultrasound Med, 2024, 43(8): 1521-1533. DOI: 10.1002/jum.16475.
[7] 陈莹, 陆健, 张涛. 256层iCT扫描联合CTA血管重建技术在肺叶内型肺隔离症诊断中的应用[J]. 中国临床医学影像杂志, 2020, 31(10): 723-726. DOI: 10.12117/jccmi.2020.10.010.
Chen Y, Lu J, Zhang T. Application of 256 iCT scanning with CTA reconstruction technique in the diagnosis of intrapulmonary sequestration [J]. J Chin Clin Med Imaging, 2020, 31(10): 723-726. DOI: 10.12117/jccmi.2020.10.010.
[8] Gabelloni M, Faggioni L, Accogli S, et al. Pulmonary sequestration: What the radiologist should know[J]. Clin Imaging, 2021, 73:61-72. DOI: 10.1016/j.clinimag.2020.11.040.
[9] Zheng W, Zhang M, Wu W, et al. Three-dimensional CT angiography facilitates uniportal thoracoscopic anatomic lung resection for pulmonary sequestration: a retrospective cohort study[J]. J Cardiothorac Surg, 2022, 17(1): 218. DOI: 10.1186/s13019-022-01975-8.
[10]Lee EY, Tracy DA, Mahmood SA, et al. Preoperative MDCT evaluation of congenital lung anomalies in children: comparison of axial, multiplanar, and 3D images[J]. AJR Am J Roentgenol. 2011, 196(5): 1040-1046. DOI: 10.2214/AJR.10.5357.
[11]Johnson PT, Schneider R, Lugo-Fagundo C, et al. MDCT Angiography With 3D Rendering: A Novel Cinematic Rendering Algorithm for Enhanced Anatomic Detail[J]. AJR Am J Roentgenol, 2017, 209(2): 309-312. DOI: 10.2214/AJR.17.17903.
[12]Dappa E, Higashigaito K, Fornaro J, et al. Cinematic rendering-an alternative to volume rendering for 3D computed tomography imaging[J]. Insights Imaging, 2016, 7(6): 849-856. DOI: 10.1007/s13244-016-0518-1.
[13] Eid M, De Cecco CN, Nance JW Jr, et al. Cinematic Rendering in CT: A Novel, Lifelike 3D Visualization Technique[J]. AJR Am J Roentgenol, 2017, 209(2): 370-379. DOI: 10.2214/AJR.17.17850.
[14]Ayloo SM, Addeo P, Buchs NC, et al. Intralobar pulmonary sequestration with an aberrant artery arising from the celiac trunk[J]. Eur J Cardiothorac Surg, 2011, 39(3): 418. DOI: 10.1016/j.ejcts.2010. 06.026.
[15]贾慧敏. 小儿肺隔离症的病因与解剖学研究进展[J]. 临床小儿外科杂志, 2018, 17(5): 325-327. DOI: 10.3969/j.issn.1671-6353. 2018. 05. 002.
Jia HM.Pathogenesis and anatomy of pulmonary sequestration in children [J]. J Clin Ped Sur, 2018, 17(5): 325-327. DOI: 10.3969/j.issn.1671-6353.2018.05.002.
[16]王啸江, 韩丹丹, 段斌, 等. 多层螺旋CT增强扫描联合CTA血管重建技术在肺叶内型肺隔离症诊断中的应用价值[J]. 中国医学工程, 2023, 31(11): 13-17. DOI: 10.19338/j.issn.1672-2019.2023.11.003.
Wang XJ, Han DD, Duan B, et al. Use of multislice contrast-enhanced scanning combined with CTA revascularization for diagnosis of intralobar lung sequestration [J]. China Medical Engineering, 2023, 31(11): 13-17. DOI: 10.19338/j.issn.1672-2019.2023.11.003.
[17]王乃武, 王君鑫, 刘军峰, 等. MSCT在肺隔离症诊断中的应用价值[J]. 医学影像学杂志, 2020, 30(8): 1372-1375.
Wang NW, Wang JX, Liu JF, et al. The application value of MSCT in clinical diagnosis and treatment for pulmonary sequestration[J]. J Med Imaging, 2020, 30(8): 1372-1375.
[18]Wei Y, Li F. Pulmonary sequestration: a retrospective analysis of 2625 cases in China[J]. Eur J Cardiothorac Surg, 2011, 40(1): e39-e42. DOI: 10.1016/j.ejcts.2011.01.080.
[19]朱林, 郭飞. 肺隔离症多层螺旋CT影像学特点及临床特征[J]. 赣南医学院学报, 2021, 41(9): 960-964. DOI: 10.3969/j.issn.1001-5779. 2021.09.018.
Zhu L, Guo F. MSCTimaging characteristics and clinical characteristics of pulmonary isolation disease [J]. Journal of Gannan Medical University, 2021,41(9): 960-964. DOI: 10.3969/j.issn.1001-5779. 2021. 09.018.
[20]王德超, 孙增涛. 肺隔离症供血动脉CTA对栓塞治疗的指导价值[J]. 医学影像学杂志, 2020, 30(12): 2213-2216.
Wang DC, Sun ZT. The guiding value of pulmonary sequestration artery CTA in embolization therapy [J]. J Med Imaging, 2020, 30(12): 2213-2216.
[21] 李晓军, 李诚, 周蓉, 等. CT对肺隔离症的诊断及介入治疗的临床指导价值[J]. 医学影像学杂志, 2023, 33(10): 1792-1795.
Li XJ, Li C, Zhou R, et al. The diagnosis and clinical value of compute of CT angiography for guiding therapeutic planning of patients with pulmonary sequestration[J]. J Med Imaging, 2023, 33(10): 1792-1795.
[22] 谢明汛, 张枢书, 龚明福, 等. 罕见部位肺隔离症CT表现及误诊分析[J]. 中华肺部疾病杂志（电子版）, 2020, 13(2): 247-250. DOI: 10.3877/cma.j.issn.1674-6902.2020.02.023.
Xie MX, Zhang SS, Gong MF, et al. CT finding and misdiagnosis analysis of pulmonary sequestration in rare locations [J]. Chin J Lung Dis (Electronic Edition), 2020, 13(2): 247-250. DOI: 10.3877/cma.j.issn.1674-6902.2020.02.023.