国际医学放射学杂志2025，Vol.48Issue(3)：300-305,6.DOI:10.19300/j.2025.L21740
基于CT平扫的三维CT支气管血管成像在肺结节解剖性肺段切除术路径导航中的价值
Value of three-dimensional CT bronchial angiography based on non-contrast CT in pathway navigation of anatomical lung segmentectomy for pulmonary nodules
摘要
Abstract
Objective To explore the clinical value of three-dimensional CT bronchial angiography(3D-CTBA)reconstruction based on non-contrast chest CT in guiding surgical approach for anatomical pulmonary segmentectomy of pulmonary nodules.Methods This retrospective study included 20 patients who underwent anatomical pulmonary segmentectomy guided by non-contrast CT(plain scan group)and 3D-CTBA navigation,and 20 patients guided by contrast-enhanced 3D-CTBA(enhanced group).Differences in clinical data(age,sex,body mass index,operative time,intraoperative blood loss,duration of chest drainage,and postoperative hospital stay)and CT imaging parameters[subjective 3D-CTBA image quality score,image accuracy assessment,CT scan cost,nodule diameter,consolidation-to-tumor ratio(CTR),proportion of pure ground-glass nodules(CTR=0),and effective radiation dose]were analyzed using t-tests,Mann-Whitney U tests,Chi-square tests,or Fisher's exact test.Inter-rater agreement for image quality and anatomical accuracy was assessed using Cohen's Kappa and Gwet's AC1.Results There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).Interobserver agreement for subjective image quality and anatomical accuracy was high(κ≥0.75;AC1≥0.80).No significant differences were observed in subjective image quality scores or anatomical accuracy between the two groups(all P>0.05).The cost of CT examination in the plain scan group was lower than that in the enhanced scan group.The effective radiation dose in the plain scan group was lower than that in the enhanced scan group(P<0.05).No significant differences were found in other objective imaging metrics or surgical outcome measures(all P>0.05).Conclusion 3D-CTBA reconstruction based on non-contrast CT provides comparable intraoperative navigation value to contrast-enhanced 3D-CTBA in anatomical segmentectomy for pulmonary nodules,with the added benefits of lower cost and reduced radiation exposure,making it suitable for broader clinical adoption.关键词
肺结节/体层摄影术,X线计算机/三维CT支气管血管成像/解剖性肺段切除术/胸腔镜Key words
Pulmonary nodules/Tomography,X-ray computed/Three-dimensional computed tomography bronchography and angiography/Anatomical pulmonary segmentectomy/Thoracoscopy分类
特种医学引用本文复制引用
刘文,赵志维,朱海涛,陈圣杰,郁辉,张龙江,曹雄锋..基于CT平扫的三维CT支气管血管成像在肺结节解剖性肺段切除术路径导航中的价值[J].国际医学放射学杂志,2025,48(3):300-305,6.基金项目
镇江市重点研发计划社会发展项目(SH2023017) （SH2023017）
江苏大学医教协同创新基金重点项目(JDY2023003) （JDY2023003）
江苏省社会发展面上项目(BE2023759) （BE2023759）
