64 排 CT 气道成像技术在气道异物检查中的临床应用

目的：评价64排CT气道成像技术对气管支气管异物检查的诊断价值。方法对50例临床怀疑气道异物的患者应用GE Light Speed 64排容积CT（VCT）进行容积扫描，将所得的容积数据经0.625 mm重建后传至工作站，运用CT仿真内窥镜（CTVE）、多平面重组技术（MPR）、容积再现技术＋透明化处理（VR＋Raysum）、最小密度投影（MinP）对图像进行后处理重建，以支气管镜检查为金标准，评估64排CT检查的敏感性和特异性，并采用χ2检验比较不同后处理方法与支气管镜诊断气管异物形态符合率。结果64排CT扫描结合气道成像技术诊断气道异物的敏感性为100%，特异性为60%，准确率为96%；不同后处理方法（CTVE、MPR、VR＋Ray-sum、MinP 4种方法结合）诊断异物形态与支气管镜检查的符合率分别为：98%、87%、82%、42%、100%，不同后处理方法与支气管镜诊断气管异物形态符合率之间差异有统计学意义（χ2=4.810，P＜0.05）。结论64排CT气道成像结合不同后处理方法能够提高气道异物诊断的准确性，不同后处理方法联合应用诊断异物形态对指导内窥镜检查或手术有重要意义。

Clinical application of 64 rows CT airway imaging in the diagnosis of tracheal bronchus foreign body

Objective To evaluate the value of 64 rows CT airway imaging in the diagnosis of tracheal bronchus foreign body. Methods Fifty patients with suspected airway foreign body underwent GE Light Speed 64 rows VCT volume scan. The volume data after 0.625 mm reconstruction was send to the workstation, and was recon-structed with CTVE, MPR,VR＋ Raysum, MinP. Then taking bronchoscopy as a gold standard, we assessed the sensi-tivity and specificity of 64 rows CT. And we compared the coincidence rate between various post-processing method of airway foreign body and bronchoscopy by Chi square test. Results The sensitivity of 64 rows CT airway imaging in the diagnosis of airway foreign body was 100%, the specificity of it was 60%, and the accuracy of it was 96% . The coincidence rate were respectively 98%, 87%, 82%, 42%,100% , there was significant difference （χ2=4.810, P〈0.05） between bronchoscopy and different post-processing methods （CTVE, MPR, VR＋Ray-sum, MinP, four methods union） in the diagnosis of foreign body shape. Conclusion 64 rows CT airway imaging with different post-processing meth-ods can improve the diagnostic accuracy of airway foreign body, and different post-processing methods in the diagnosis of foreign body shape is significant for guiding the endoscopy or surgery.