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目的 明确肺韧带对下胸部疾病螺旋CT表现的影响及其解剖学基础。方法 观察4例尸体横断面标本的肺韧带形态及附着点。并搜集经临床和病理证实的下胸部疾病 5 7例 ,采用螺旋CT增强扫描。在螺旋CT图像上 ,观察肺韧带对下胸部疾病的影响及其影像学表现特征 ,结合实体标准 ,分析其解剖学基础。结果 尸体横断面标本上 ,肺韧带位于下肺静脉下方 ,为连接肺下叶与纵隔的胸膜反褶 ,右侧附着于食管 ,左侧附着于食管或降主动脉。螺旋CT上 ,40例胸腔积液和 7例气胸压迫肺下叶致肺不张 ,肺韧带固定肺下叶 ,使压缩的肺下叶不向上达肺门 ;40例胸腔积液中 ,肺韧带将胸腔积液分隔成前、后两部分 ;7例下叶肺癌及 3例炎性病变直接累及肺韧带 ,使其呈结节状或鸟嘴状增厚。结论 肺韧带固定肺下叶 ,影响下胸部疾病 (肺不张、胸腔积液和气胸等 )的影像学表现 ;邻近肺下叶和纵隔病变可直接累及肺韧带
Objective To determine the effect of pulmonary ligament on the performance of spiral CT in lower thoracic diseases and its anatomical basis. Methods The morphology and attachment points of lung ligaments in 4 cases of coronal cross-section specimens were observed. Fifty-seven cases of lower thoracic disease confirmed by clinical and pathology were collected and scanned by spiral CT. On the spiral CT images, observe the lung ligament on the lower chest disease and imaging features, combined with physical standards, analysis of its anatomical basis. Results The coronal cross-sectional specimens, lung ligament is located below the inferior pulmonary veins, connecting the lower lobe of lung and mediastinal pleural deformity, the right attached to the esophagus, the left attached to the esophagus or descending aorta. Spiral CT, 40 cases of pleural effusion and 7 cases of pneumothorax compression of the lower lung caused by atelectasis, pulmonary ligament fixation of the lower lobe, the compressed lower lobe did not reach the hilar; 40 cases of pleural effusion, the pulmonary ligament The pleural effusion was divided into two parts before and after; 7 cases of lower lobe lung cancer and 3 cases of inflammatory lesions directly involving the pulmonary ligament, making it nodular or bill-like thickened. Conclusion Pulmonary ligament fixation of the lower lobe of the lung affects the imaging manifestations of lower thoracic ailments (atelectasis, pleural effusions, pneumothorax, etc.); adjacent lower lobe and mediastinal lesions may directly affect the pulmonary ligament