128层CT低剂量扫描在幼儿气管、支气管非金属异物诊断中的价值

目的:探讨128层螺旋CT低剂量扫描在幼儿气管支气管阴性异物诊治中的临床应用价值.方法:回顾性分析经支气管内镜检取异物的16例幼儿气管支气管非金属异物患者的128层螺旋CT影像学资料.128层CT低剂量扫描选用个体化方案(100或120kV; Eft.mAs:30～40mA;CARE D()SE 4D:打开)；层厚3mm；螺距:1.4；时间1.33s;常规1mm原始重组,记录每位患儿的平均有效剂量(mGy),将容积数据进行多平面重组(MPR)、曲面重组(CPR)、最小密度投影(Min-IP),并将CT与内镜结果对比分析.结果:16例低剂量扫描图像均符合诊断要求,128层CT发现异物位于气管5例,气管分叉上方1例,右侧主支气管及分支异物5例,左侧主支气管及分支异物4例,双侧支气管均有异物1例.128层螺旋CT低剂量扫描技术在幼儿气管支气管非金属异物诊断中的敏感度、准确度分别为100％、94.2％.结论:幼儿气管支气管非金属异物128层CT低剂量扫描能满足诊断,准确评估异物大小、位置、形态及肺部并发症,能减少不必要的支气管镜检及弥补X线平片的不足,具有重要的临床应用价值.

Value of low-dose 128 slice spiral CT in diagnosis and treatment of endo-tracheal and bronchial negative foreign bodies of children

Objective：To investigate the value of low dose 128-slice spiral CT in diagnosis and treatment of endo-tracheal/bronchial negative foreign bodies for children in clinical application.Methods：16 children,who underwent tracheoscopy for taking out negative foreign body in endo-trachea/bronchi,were reviewed with their imaging data of 128-slice spiral CT.The low dose 128-slice spiral CT choose the individualized programs（100 or 120 kV;Eft.mAs 30~40 mA;CAREDose： 4D： open）;with layer thickness of 3 mm;helical pitch 1.4;time of 1.33 s;and conventional original reconstruction interval of 1 mm.The mean effective dosage of radiation（mGy） was measured for all patients.Post-processing techniques included multi-planar reconstruction（MPR）,curved planar reformation（CPR）,and minimum intensity projection（Min-Ip）.Finally,CT data were compared with these by tracheoscopy.Results：The 16 children＇ images of low dose scanning were accorded with diagnotic requirements.128-slice spiral CT found 5 cases of foreign body existed in the trachea,1 case above the bifuration of two main trachea,5 cases in the right main bronchus and its branches,4 cases in the left main bronchus and its branches,1 case in left and right bronchus cach.The sensitivity and accuracy of low dose 128-slice spiral CT in diagnosing the endo-tracheal/bronchial negative foreign bodies were 100% and 94.2% respectively.Conclusion：The low dose of 128-slice spiral CT with post-processing techniques is satisfactory with diagnosis of endo-tracheal/bronchial negative foreign bodies in children.The exact size,location,shape of foreign bodies as well as pulmonary complications could be accurately evaluated,unnecessary bronchoscopy could be avoided and the shortcoming of chest radiography could be made up.It has valuable in clinic application.