多层螺旋CT对小儿气管支气管异物的诊断价值(附360例分析)

目的:探讨多层面螺旋CT(MSCT)及三维重建技术对小儿气管支气管异物的诊断价值。方法:对2006年1月至2011年5月期间临床高度怀疑为气管支气管异物及不明原因反复肺部感染的患儿,用多层面螺旋CT行薄层扫描并结合三维重建,分析有无异物及确定异物位置,并经手术证实的资料完整的患儿360例,行回顾性分析。结果:气管异物63例,左侧支气管异物131例,右侧支气管异物166例;合并阻塞性肺气肿190例,阻塞性肺炎97例,肺不张7例,肺脓肿1例,气管破裂1例,纵隔气肿3例,胸水1例。以上病例均行纤维支气管镜检查及异物取出术,并顺利取出异物。结论:MSCT及三维重建技术是一种有效诊断小儿气管支气管异物的非创伤性影像学检查技术,能较准确诊断,为临床制定治疗方案并及早治疗提供重要依据,应作为小儿气管支气管异物的首选检查方法。

Value of Multi-Slice Spiral CT Scan in Diagnosing Trackeal Foreign Body (Analysis of 360 Cases)

Objective: To study the value of Multi-Slice Spiral CT(MSCT) scan and Three-dimentional image reconstruction in diagnosing trackeal foreign body.Methods:We included pediatric patients from January 2006 to May 2011.All cases were sent for CT scan for highly suspected tracheal forein body or recurrent lung infection of unknown causes.Using the Multi-Slice Spiral CT with thin slices plus three-dimentional image reconstruction of images,the presence and location of foreign bodies were determined,followed by comfirmaion with surgery.360 pediatric patients with full clinical data were retrospectively analyzed.Results:We found 63 cases with tracheal foreign body,131 cases of left broncheal foreign body,and 166 cases of right broncheal foreign body.Observed complications were obstructive pulmonary emphysema(190 cases),obstructive pneumonia(97 cases),pulmonary atelectasis(7 cases),pulmonary abscess(1 case),tracheal rupture(1 case),mediastinal emphysema(1 case),and hydrothorax(1 case).Flexible bronchoscopy was used successfully to remove foreign bodies in all cases.Conclusion:MSCT and three dimontional image reconstruction technology is an effective,and non-invasive imaging method in diagnosing broncheal foreign bodies in pediatric patients.With it’s diagnostic acuracy,MSCT not only provide important clinical information for early diagnosis and treatment,but also can be used as first-line investigational method.