Dataset Information

Anatomical analysis of variations in the bronchus pattern of the left upper lobe using three-dimensional computed tomography angiography and bronchography.

ABSTRACT:

Background

The number of sublobar resections performed is increasing, thoracic surgeons must be familiar with bronchus anatomy and preoperative planning plays an important role in predicting anatomical variations. However, there is few report showing anatomic variations of the left upper lobe (LUL) using three-dimensional computed tomography angiography and bronchography (3D-CTAB), and no in Chinese population. The present study aimed to use 3D-CTAB to describe variations of the pulmonary bronchus of LUL in Chinese population.

Methods

In this retrospective study, we analyzed 3D-reconstruction from patients that performed lobectomy, segmentectomy or subsegmentectomy of the LUL in 2020 at Fujian Medical University Cancer Hospital's Department of Thoracic Surgery. Patients with previous LUL surgery or absence of 3D-reconstruction or without surgery were excluded.

Results

One hundred and sixty-six patients met our criteria. Branching of the left upper bronchus was classified into bifurcated type (99.4%) or trifurcated type (0.06%). The left upper divisional bronchus (B ¹⁺²⁺³) arise as bifurcated (65.65%) or trifurcated type (34.34%). Apicodorsalis bronchus (B ¹⁺²) always originated as bifurcated type, while ventralis bronchus (B ³) was either bifurcated (94.45%) or trifurcated (5.55%). Lingular bronchus (B ⁴⁺⁵) was observed as bifurcated (96.38%) or trifurcated (3.62%) type. When analyzing sublobar divisions of bronchi a total of 14 subtypes were identified, 6 of them were found in the upper divisional bronchus.

Conclusions

Bronchial anatomy of LUL is highly variable, especially in upper divisional bronchus. 3D-CTAB is a useful tool to identify variations in the bronchi pattern, we recommend preoperative planning for sublobar resection.

SUBMITTER: He H

PROVIDER: S-EPMC9011284 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Publications

Anatomical analysis of variations in the bronchus pattern of the left upper lobe using three-dimensional computed tomography angiography and bronchography.

He Hao H Wang Feng F Wang Pei Yuan PY Chen Peng P Li Wilson W L WWL Perroni Gianluca G Liu Shuo Yan SY

Annals of translational medicine 20220301 6

<h4>Background</h4>The number of sublobar resections performed is increasing, thoracic surgeons must be familiar with bronchus anatomy and preoperative planning plays an important role in predicting anatomical variations. However, there is few report showing anatomic variations of the left upper lobe (LUL) using three-dimensional computed tomography angiography and bronchography (3D-CTAB), and no in Chinese population. The present study aimed to use 3D-CTAB to describe variations of the pulmonar ...[more]

PMID: 35433944

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Project description:BackgroundA preoperative understanding of the thoracic anatomy of the patients with the quadrivial pattern of branching of the right upper lobe is key to successful surgery. We analyzed the quadrivial pattern of division of the right upper lobe bronchus of patients using three-dimensional (3D) computed tomography (CT) angiography and bronchography.MethodsA total of 212 consecutive adult patients who had undergone thoracic CT scans before surgery at the Zhujiang Hospital of the Southern Medical University from August 2020 to August 2021 was used for retrospective study. The 3D-CT images were taken using Mimics software. Radiology technicians processed all the 3D images, and thoracic surgeons confirmed the validity of all the reconstructions.ResultsSix (2.83%) were identified as having a quadrivial pattern of division of the right upper lobe bronchus with 1 female, and 5 males. Based on the number of pulmonary artery branches, 5 (83.3%) and 1 (16.7%) were classified as "trunk superior (Tr.sup) + ascending artery (A.asc) and Tr.sup + trunk inferior (Tr.inf) + ascending artery (A.asc) (1/6, 16.7%). Based on the number of ascending artery branches, the patients were also divided into type A (3/6, 50%) and type B (3/6, 50%). The patients were also divided into 1 of the following three types based on the origins of the A2: (I) A2 originates from A6 (1/6, 16.7%); (II) A2 originates from the pulmonary trunk (4/6, 66.7%); and (III) A2a originates from A3, and A2b originates from the pulmonary artery stem (1/6, 16.7%). According to the number of A1b branches, patients were divided into two types: (I) 1 branch (4/6, 66.7 %); and (II) 2 branches (2/6, 33.3 %). In the present study, anterior + central type was observed which classified into two types: (I) type Iab, the anterior vein ran from V1a to V1b (4/6, 66.7%); and (II) type Ib, the anterior vein ran from V1b only (2/6, 33.3%).Conclusions3D-CT was successfully used for analyzing the quadrivial bronchovascular patterns of the right upper lobe bronchus. Our study provides certain references to perform anatomical pulmonary segmentectomy, which should improve the success rate of operations.

Dataset Information

Anatomical analysis of variations in the bronchus pattern of the left upper lobe using three-dimensional computed tomography angiography and bronchography.

Background

Methods

Results

Conclusions

Publications

Anatomical analysis of variations in the bronchus pattern of the left upper lobe using three-dimensional computed tomography angiography and bronchography.

Similar Datasets

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