放射性胸腔胃-气道瘘的影像学诊断与介入治疗

目的：探讨放射性胸腔胃-道瘘的影像学特征及其介入治疗方法。方法：回顾性分析7例具有完整临床资料的胸腔胃-气道瘘的口服碘水造影及CT表现；X线监视下，5枚长管状、4枚气管-主支气管分支型覆膜内支架置人气道封堵瘘口。结果：口服碘水造影显示胸腔胃-气管瘘3例，胸腔胃-隆突瘘1例。胸腔胃-左主支气管瘘2例，胸腔胃-右主支气管瘘1例；cr检查详细观察胸部情况，了解瘘与临近结构的详细解剖，测量气管／支气管内径。气道覆膜内支架置人气道完全封堵了瘘口，即刻消除呛咳症状，有效控制肺部感染。患者生活质量得以提高。结论：根据口服碘水造影和螺旋CT象，结合病史可以诊断放射性胸腔胃-气道瘘；置人气道覆膜内支架封堵瘘口操作简单、安全、近期疗效明显，是一项值得推广的新技术。

The imaging diagnosis and interventional treatment for radioactive thoracostomach-airway fistula

Objective:To analyse the imaging manifestations and study the treatment for radioactive thoracostomach airway fistula.Methods:We analyzed the CT and digital radiography with water soluble medium in 7 cases with radioactive thoracostomach airway fistula retrospectively.Under the fluoroscopic guidance,9 stents were placed in 7 patients.Results:The digital radiography showed 3 thoracostomach tracheal fistulas,1 thoracostomach carina fistula,2 thoracostomach left main bronchial fistulas and 1 thoracostomach right main bronchial fistula.According to CT,we can see the pulmonary infection and know the particular anatomic structures between fistula and the near structure in details and measure the diameter of the trachea and main bronchi.All stents were placed successfully,choke after drinking and eating vanished as soon as the fistula were closed,inhalation pneumonia was cured and the quality of living was improved.Conclusion:The radioactive thoracostomach airway fistula could be diagnosed on base of the medical history,CT and digital radiography with water soluble medium.The airway covered stent placement is an effective and safe treatment for thoracostomach airway fistula.