肺CT在诊断和治疗小儿气管、支气管异物中的价值

目的 探讨肺CT在诊断和治疗小儿气管、支气管异物中的价值.方法 对怀疑气管、支气管异物的45例患儿进行肺CT检查,应用的是16层超薄CT扫描,条件为:100～150 kV,30～50 mA,层厚1 mm,CT扫描后进行多层CT影像重建.结果 45例患儿中有42例CT检查发现了异物,另外没发现异物的3例经抗生素对症治疗1周痊愈,避免了支气管镜检术.根据CT影像及异物特点,我们设计了手术方案并选择合适的异物钳,42例患儿均一次即将异物取出,肺CT所显示的异物位置、形状及体积与支气管镜检时所见基本一致.结论 应用肺CT可以准确地诊断出气管、支气管异物,CT所提示的异物位置、形状、体积对于设计手术方案和安全取出异物具有重要价值.

Clinical value of chest CT in the diagnosis and management of tracheobronchial foreign bodies

Objective The purpose of this study was to investigate the value of chest CT in the evaluation ofchildren with suspected foreign body aspiration. Methods Chest CT was performed in 45consecutive children with suspected foreign body aspiration. The patients were examined with 16-slice Multidetector CT (MDCT) using 100 ～ 150 kV,30 ～ 50 mA, 1 mm section thickness. 1.2 pitch ratio, and 0.6 ～1.0 mm reconstruction interval. multiplanar reformatted (MPR) imaging were carried out after MDCT examinations. Results Chest CT revealed all foreign bodies in 42 of the 45 patients. Three patients with suspected foreign body aspiration did not show evidence of foreign body on CT,and they were treated with antibiotics for one week. These patients avoided unnecessary operations and recovered completely. The other 42 patients had evidence of foreign bodies in their bronchi. We designed the surgerical plan and selected appropriate foreign body forceps based on the CT scans. All of the foreign bodies were removed successfully, and no severe complications were observed. The location, shape, and volume of the foreign bodies found at surgery were consistent with the CT images. Conclusion The diagnosis of foreign body aspiration of the airwayin children can be accomplished by using chest CT. It is often useful in delineating the exact shape, location, volume and form of a bronchial foreign body and can help the surgeon plan for operative bronchoscopy and safe removal of the foreign body.