小儿气道异物的多层螺旋CT诊断

目的:评价多层螺旋CT(MSCT)在小儿气道异物中的应用价值。方法:对33例怀疑气道异物的小儿患者行MSCT扫描,5例采用准直5mm,螺距1.5,9例采用准直2.5mm,螺距1.5,19例采用准直1mm,螺距1.75,对后28例CT原始图像数据行多平面重建、曲面重组、容积显示及仿真内镜成像。与喉镜、支气管镜检查对照,评价MSCT对异物的显示效果。结果:CT诊断异物32例,1例未见异常,与喉镜和支气管镜检查结果比较,其中真阳性30例,假阳性2例,假阴性1例。采用准直5mm扫描患者中异物5例,CT检出4例,未检出1例,采用准直2.5mm和1mm扫描患者中异物26例,CT显示26例。多平面重建、曲面重组和容积显示均显示25例,仿真内镜成像显示26例。CT清晰地显示了异物的部位、大小、形态及伴随征象,与喉镜和支气管镜检查结果一致。结论:MSCT及其后处理重建成像能清晰显示气道异物,对小儿气道异物的诊断和治疗有重要价值,推荐采用低剂量薄层扫描,并常规进行后处理成像。

MSCT Diagnosis of Air Tract Foreign Body in Children

Objective:To assess the clinical value of MSCT in the examination of air tract foreign bodies in children.Methods:33 patients suspected of having foreign bodies aspiration were examined using MSCT,5 of them were scanned with collimation 5 mm,pitch 1.5,9 were scanned with collimation 2.5mm,pitch 1.5,and 19 were scanned with collimation 1mm, pitch 1.75.The original CT data scanned with collimation 2.5mm and 1mm were reconstructed with MPR,CPR,VR and CTVE to demonstrate the foreign bodies in air tract,the results were evaluated and compared with those of laryngoscopy and fiberoptic bronchoscopy.Results:There were 32 cases with foreign bodies in air tract demonstrated by CT,and 1 case was normal concluded from his CT image.Compared with laryngoscopy and bronchoscopy findings,30 were true positive,2 were false positive,and 1 was false nagative.4 were demonstrated and 1 was not in cases scanned with collimation 5mm.There were 26 cases with foreign bodies in air tract out of 28 patients with thin-slice scanning,and all were demonstrated by CT.Among 26 cases,25 were demonstrated with MPR image,CPR image and VR image respectively and 26 were demonstrated with CTVE image.The position,size,shape and accompanying signs of foreign bodies were clearly demonstrated by CT and they were coincident with laryngoscopy and bronchoscopy findings.Conclution:MSCT and its post image processing could clearly demonstrate foreign bodies in air tract,and it could contribute greatly to clinical diagnosis and treatment,thin-slice thickness and low-dose scanning with post image processing was recommended.