目的 用冠状位重建及合适的窗 宽窗位显示肺移植术后吻合口狭窄。方 法 回顾性分析110例肺移植后不同时期患 者的胸部MSCT图像，抽取临床确诊和怀疑 吻合口狭窄共37例患者的72次CT图像，对 轴位CT图像行冠状位重建，以及调节合适 的窗宽窗位显示吻合口狭窄的情况。比较 轴位肺窗图像与调节窗宽窗位后的冠状位 图像两者检出吻合口狭窄的情况，两种图 像分别由三位有经验的主治以上医师阅片 判断有否气道狭窄，结果用ROCFIT软件进 行ROC(受试者操作特征曲线)分析，并用 Excel 2010绘制ROC曲线图。结果 冠状位 合适的窗宽窗位图像的ROC曲线下面积大 于肺窗轴位图像的ROC曲线下面积。轴位 图像的截距(a值)为0.6916，斜率(b值)为 1.0441，曲线下面积(Az)为0.6838；冠状 位图像的a值为0.7856，b值为0.9952， Az为0.7112。两种图像诊断的ROC曲线及 Az明显不同，两者有显著差异，配对t检 验，(P＜0.001)。结论 肺移植后患者 MSCT肺部检查，冠状位重建及合适的窗宽 窗位图像可以更敏感地发现吻合口狭窄， 而且还能显示狭窄段支气管与邻近大血管 的关系，为临床早期诊断和治疗提供依 据。

Objective To discuss the indication of airway stenosis in a consecutive series of bronchial anastomosis after lung transplantation in our hospital. Methods We performed a retrospective imaged study on 110 cases of lung transplants in our hospital from January 2003 to April 2016. Sixty-two cases were subjected to single lung transplants, and fortyeight to bilateral sequential single Iung transpIantation. There were totally l58 bronchial anastomoses. 72 MSCT imaging which confirmed or suspected anastomosis stenosis were selected to further handle from 37 cases. Changed the axial to coronal section, then adjusted the window width and window level were fitted to show the airway stenosis. Compared the ability of distinguish airway stenosis between this two kinds of images, three experience physician readed this two groups imaging using ROC analysis. ROC curved was made by Excel 2010. All recipients received long-term MSCT follow-up. Fibrobronchoscopic examinations were done when necessary. Results ROC analysis indicated that there were significant difference (P＜0.001) between coronal and axial imaging groups with a=0.7856, b=0.9952, Az=0.7112 on the former and a=0.6916, b=1.0441, Az=0.6838 on the latter. Conclusion Reconstruction Coronal imaging can more effectively show airway stenosis after lung transplantation than the axial ones．