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Bronchial anatomy of left lung: a study of multi-detector row CT

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Abstract

Familiarity with prevailing pattern and variations in the bronchial tree is not only essential for the anatomist to explain bronchial variation in bronchial specimens, but also useful for guiding bronchoscopy and instructing pulmonary segmental resection. The purpose of this study was designed to demonstrate various branching patterns of left lung with 3D images, with special attention given to identify the major types at transverse thin-section CT. Two hundred and sixteen patients with routine thorax scans were enrolled. The images of bronchial tree, virtual bronchoscopy were reconstructed using post-processing technique of multi-detector row CT. We attempted to classify the segmental bronchi by interpreting the post-processing images, and identified them in transverse thin-section CT. Our results showed that the segmental bronchial ramifications of the left superior lobe were classified into three types mainly, i.e., common stem of apical and posterior segmental bronchi (64%, 138/216); trifurcation (23%, 50/216); common stem of apical and anterior segmental bronchi (10%, 22/216), and they could be identified at two typical sections of transverse thin-section CT. There were two major types in left basal segmental bronchi, i.e., bifurcation (75%, 163/216), trifurcation (18%, 39/216), and they could also be identified at two typical sections of transverse thin-section CT. In conclusion, our study have offered simplified branching patterns of bronchi and demonstrated various unusual bronchial branching patterns perfectly with 3D images, and have also revealed how to identify the main branching patterns in transverse thin-section CT.

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Abbreviations

3D:

Three dimensional

2D:

Two dimentional

VB:

Virtual bronchoscopy

B1:

Apical segmental bronchus

B2:

Posterior segmental bronchus

B3:

Anterior segmental bronchus

B4:

Superior lingular segmental bronchus

B5:

Inferior lingular segmental bronchus

B6:

Superior segmental bronchus

B7:

Medial basal segmental bronchus

B8:

Anterior basal segmental bronchus

B9:

Lateral basal segmental bronchus

B10:

Posterior basal segmental bronchus

B1 + 2:

Common stem of apical and posterio segmental bronchus

B1 + 3:

Common stem of apical and anterior segmental bronchus

B7 + 8:

Common stem of anterior and medial basal segmental bronchus

B9 + 10:

Common stem of lateral and posterior basal segmental bronchus

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Authors and Affiliations

  1. Shandong Medical Imaging Research Institute, Shandong University, 324#, Jingwu Road, Jinan, 250021, Shandong, People’s Republic of China

    Xinya Zhao, Cheng Liu, Jian Sun & Tao Wang

  2. Shandong Provincial Hospital, Jinan, People’s Republic of China

    Yuanrong Ju, Jianfeng Li & Min Huang

Authors
  1. Xinya Zhao
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  2. Yuanrong Ju
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  3. Cheng Liu
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  4. Jianfeng Li
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  5. Min Huang
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  6. Jian Sun
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  7. Tao Wang
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Corresponding author

Correspondence to Tao Wang.

Additional information

Xinya Zhao and Yuanrong Ju contributed equally to this work.

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Zhao, X., Ju, Y., Liu, C. et al. Bronchial anatomy of left lung: a study of multi-detector row CT. Surg Radiol Anat 31, 85–91 (2009). https://doi.org/10.1007/s00276-008-0404-8

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  • DOI: https://doi.org/10.1007/s00276-008-0404-8

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