多层面CT仿真内镜对中央气道良性病变的评价

目的：探讨多层螺旋CT仿真内镜（virtual endoscopy,VE)在中央气道良性病变评价中的价值。材料和方法：29例中央气道良性病变，包括解剖性异常5例（气管性支气管2例、气管憩室1例、先天性支气管闭锁1例、食管气管瘘1例），炎症性病变14例（支气管内膜结核9例、复发性多软骨炎3例、慢性炎症瘢痕2例）和其他10例（外伤性气管支气管撕裂2例、支气管腔内血凝块1例、支气管腔内痰栓5例、血管压迫2例）。痰液经CT复查或纤维支气管镜证实，其余病例均经纤维支气管镜（Fibrobronchoscope,FOB)及活检证实。采用多层面CT机，准直2．5mm或5mm,p=1.25或1．75，重建间隔1.6mm或2mm，容积性VE观察。结果：解剖性异常和痰液栓VE明确诊断（12／12），显示详细；其他气道良性疾病能一定程度上显示补充信息，对有辅助定位及判断良性狭窄的程度或范围有一定的诊断价值。与FOB有较好的一致性（22／24）。结论：VE能充分显示良性病变，对横断面起很好的补充说明作用。解剖性异常和多数痰液栓能明确诊断，可免除FOB或重复检查。

Clinical Application of Multi - slice Helical CT Virtual Endoscopy in Central Airway Benign Diseases

Purpose: To investigate the clinical application and value of Multi - slice Helical CT virtual endoscopy in central airway benign diseases.Materials and Methods: Twenty - nine patients of central airway benign diseases (2 tracheal bronchus, 1 trachea diverticulum, 1 bronchus atresia, 1 esophageal trachea fistula^ bronchial tuberculosis,3 relapsing polychondritis,2 inflammatory scar,2 lancination, 1 blood clot,5 mucus blots,and 2 vessel oppression) underwent multi - slice helical CT virtual endoscopy(VE) examination (collimation 2.5mm or 5.0mm,p = 1.25 or 1.75, reconstruction interval 1.6mm or 2mm). Mucus was confirmed by follow - up CT exam and fibrobron - choscope(FOB) , the others by fibrobronchoscope (FOB) . Results: Anatomical abnormalities and mucus were all diagnosed definitely and showed clearly, the others were showed complemental information which were useful for location and narrow estimation. The coherence with FOB was very good (22/24) .Conclusion:Benign diseases can be showed sufficiently on virtual endoscopy. VE did the complemental role on the diagnoses. Anatomical abnormality and mucus could be diagnosed definitely, which could avoid FOB or repeated examination.