Table1_Analysis of pulmonary artery variation based on 3D reconstruction of CT angiography.DOCX

Objective: The aim of this study is to acquire pulmonary CT (Computed tomography) angiographic data for the purpose of creating a three-dimensional reconstruction. Additionally, we aim to analyze the features and deviations of the branches in both pulmonary lobes. This information is intended to serve as a more comprehensive and detailed reference for medical professionals when conducting preoperative evaluations and devising surgical plans.
Method: Between August 2019 and December 2021, 420 patients were selected from the thoracic surgery department at the First Hospital of Jilin University, and underwent pulmonary 64 channel contrast enhanced CT examinations (Philips ICT 256). The images were acquired at a 1.5 mm slice thickness, and the DCM files that complied with DICOM (Digital Imaging and Communications in Medicine) standards were analysed for 3D (three dimensional) reconstruction using Mimics 22.0 software. The reconstructed pulmonary artery models were assessed by attending chest surgeons and radiologists with over 10 years of clinical experience. The two-dimensional image planes, as well as the coronary and sagittal planes, were utilized to evaluate the arteries. The study analyzed the characteristics and variations of the branches and courses of pulmonary arteries in each lobe of the lungs, with the exception of the subsegmental arterial system. Two chest surgeons and two radiologists with professional titles-all of whom had over a decade of clinical experience-jointly evaluated the 3D models of the pulmonary artery and similarly assessed the characteristics and variations of the branches and courses in each lobe of the lungs.
Results: Significant variations were observed in the left superior pulmonary artery across the 420 subjects studied. In the left upper lobe, the blood supply of 4 arteries accounted for 50.5% (n = 212), while the blood supply of 2 arteries in the left lower lobe was the most common, accounting for 79.5% (n = 334). The greatest variation in the right pulmonary artery was observed in the branch supply of the right upper lobe mediastinal artery. In the majority of cases (77.9%), there were two arteries present, which was the most common configuration observed accounting for 64% (n = 269). In the right inferior lobe of the lung, there were typically 2–4 arteries, with 2 arteries being the most common configuration (observed in 79% of cases, n = 332).
Conclusion: The three-dimensional reconstruction of pulmonary artery CT angiography enables clear observation of the branches and distribution of the pulmonary artery while also highlighting any variations. This technique holds significant clinical value for preoperative assessments regarding lesions and blood vessels.

研究目的：本研究旨在获取肺动脉CT（Computed Tomography，CT）血管造影数据以开展三维重建，同时分析双侧肺叶内动脉分支的特征与变异，为临床医师开展术前评估与制定手术方案提供更全面细致的参考依据。
方法：2019年8月至2021年12月期间，研究团队从吉林大学第一医院胸外科纳入420例患者，对其实施64层对比增强CT检查（设备型号：Philips ICT 256），扫描层厚为1.5mm。随后采用符合DICOM（Digital Imaging and Communications in Medicine，医学数字成像和通信）标准的DCM文件，通过Mimics 22.0软件完成三维重建。由具备10年以上临床经验的胸外科主治医师及放射科医师对重建后的肺动脉模型进行评估，借助二维图像平面、冠状面及矢状面完成动脉评估。本研究分析了各肺叶肺动脉分支及走行的特征与变异（亚段动脉系统除外）。另有2名具备十年以上临床经验的胸外科医师与2名放射科医师联合评估肺动脉三维模型，同样对各肺叶肺动脉分支及走行的特征与变异进行分析。
结果：在420例研究对象中，左肺动脉上支存在显著解剖变异。左肺上叶由4支动脉供血的情况占比50.5%（n=212）；左肺下叶以2支动脉供血最为常见，占比79.5%（n=334）。右肺动脉的最大变异见于右肺上叶纵隔动脉分支供血模式。多数病例（77.9%）存在2支动脉，最常见的构型占比为64%（n=269）。右肺下叶通常存在2~4支动脉，其中2支动脉为最常见构型（占79%，n=332）。
结论：肺动脉CT血管造影三维重建技术可清晰显示肺动脉的分支与分布情况，同时凸显其解剖变异，该技术在针对病变与血管的术前评估中具备重要临床价值。