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Pulmonary Arterial Anatomical Patterns: A Classification Scheme Based on Lobectomy and 3D-CTBA.

Zhuolin Xie1, Xinyu Zhu1, Feifei Li2

  • 1Department of Thoracic Surgery, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

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Summary

Three-dimensional computed tomography bronchography and angiography (3D-CTBA) effectively evaluates pulmonary artery anatomy. This study proposes a new classification for pulmonary arterial variants, aiding surgeons in preoperative planning for lobectomy.

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Area of Science:

  • Thoracic surgery
  • Medical imaging
  • Anatomy

Background:

  • Preoperative assessment of pulmonary vascular and tracheal anatomy is crucial for surgical success.
  • Advancements in 3D reconstruction and AI have enhanced 3D-CTBA capabilities.

Purpose of the Study:

  • To apply CT angiography and Exoview 3D reconstruction to evaluate the pulmonary arterial tree and its variants.
  • To develop a practical anatomical typing of the pulmonary arterial tree for lobectomy teaching and surgical planning.

Main Methods:

  • Analysis of 358 patients' pulmonary artery anatomy using 2D CT and 3D reconstruction.
  • Detailed examination of emanation site, alignment, and branching patterns of pulmonary arteries.
  • Classification based on surgical lobectomy habits.

Main Results:

  • Observation of diverse pulmonary artery types in 358 cases.
  • Evaluation of the complete pulmonary artery tree with frequency counts of major branches.
  • Data collection aligned with anatomical lobectomy surgical practices.

Conclusions:

  • 3D-CTBA is a valuable tool for assessing pulmonary artery anatomy.
  • A practical classification scheme for pulmonary arterial patterns, based on lobectomy and 3D-CTBA, has been established.
  • The findings support clinical teaching and preoperative preparation for anatomical lobectomy.