Preoperative 3DCT angiography for pulmonary segmentectomy

Abstract

For safe and accurate segmentectomy, it is important to understand the anatomic features of the pulmonary vascular branch before performing the operation.
We report the usefulness of three-dimensional computed tomography (3DCT) simulation for segmentectomy.
It is necessary to obtain contrast between the pulmonary artery and vein in single-time imaging. In this study, we investigated 2 imaging procedures.
A is the normal procedure for 3DCT, and B is a new procedure that involves injecting normal saline after injecting the contrast agent.
We investigated 22 people who had undergone segmentectomy from January 2008 to November 2009. Ten people underwent procedure A and 12 underwent procedure B.
The ratio of good contrast images to poor contrast images for 3DCT was 1: 9 for procedure A and 9: 3 for procedure B. We set the region of interest (ROI) in the pulmonary artery and left atria in the CT image and estimated the CT number.
We calculated the difference in the mean average CT number for the pulmonary artery and left atria for both procedures. The difference was 22.1 for procedure A and 106.6 for procedure B.
Procedure B provided a considerably better contrast image than that provided by procedure A and was useful in obtaining a contrast image between the pulmonary artery and pulmonary vein in single-time imaging.