CT仿真支气管镜在儿童可疑支气管异物诊断中的应用

目的 探讨儿童CT仿真支气管镜对可疑小儿支气管异物和支气管肺炎的鉴别诊断价值。方法 回顾性分析29例反复咳嗽及发热、支气管异物不能排除的患儿资料，所有患者分别行CT仿真支气管镜（CTVB）检查，24h内行硬管支气管镜检查术。结果 29例中，CTVB检查发现支气管异物12例，支气管肺炎17例。除将痰痂1例、支气管内肉芽1例误为异物外，其它与硬管支气管镜检查均相符。结论 CTVB对鉴别小儿支气管异物和支气管肺炎有一定特异性，当胸部X线检查未提示异物存在，而临床表现显示有异物可能时，可考虑行CTVB检查，若亦未发现异物，不需再进行硬管支气管镜检查。

The clinical application of CT virtual bronchoscopy in the children suspected with a bronchial foreign body

Objective To investigate the usefulness of CT virtual bronchoscopy(CTVB) in the evaluation and management of suspected foreign body aspiration and bronchopneumonia in children. Methods From July 2008 to October 2009, 29 cases suspected with a foreign body in the bronchus, due to prolonged fever and repeated cough, were included in this study. CT virtual bronchoscopy was performed in all the patients. Then, rigid bronchoscopy images were obtained within 24hs. Results With CTVB, foreign bodies were detected in 12 cases and bronchopneumonia were revealed in 17 cases. The result was consistent with rigid bronchoscopy except one sputum scab and one bronchus granulation was misdiagnosed as a foreign body. Conclusion CT virtual bronchoscopy is sensitive and specific to confirm foreign body aspiration or bronchopneumonia in children.If the chest X ray is normal but an aspirated foreign body is suspected, CT virtual bronchoscopy should be considered to avoid unnecessary rigid bronchoscopy.