多层螺旋CT多平面重建诊断支气管异物

目的 评价多层螺旋CT多平面重建（multiple planar reconstruction,MPR）对支气管异物的诊断价值.方法 对有明确或可疑呼吸道异物吸入史,怀疑为支气管异物的患者180例,无呼吸道异物吸入史,有自发性皮下气肿、气胸患者6例行肺多层螺旋CT平扫及MPR重建,诊断有异物者行支气管镜检查及异物取出术,无异物者观察或保守治疗.分析MPR对支气管异物的显示情况及诊断价值.结果 在180例可疑支气管异物患者中,MPR显示165例有异物影,15例未见异物.165例有异物影者均行支气管镜检查术,发现异物163例（均为单侧）,黏脓痰阻塞支气管腔2例,异物及脓痰位置与MPR所示一致,诊断敏感性为98.8%（163/165）,假阳性率1.2%（2/165）.15例未见异物者,随访观察1个月以上均未见异常.6例自发性皮下气肿患者MPR检查均未见异物,经保守治疗均治愈,诊断特异性为100%（21/21）,假阴性率为0（0/21）.结论 多层螺旋CT MPR技术在支气管异物诊断中具有重要的临床应用价值.（中国眼耳鼻喉科杂志,2010,10：295-297）

Clinical applications of multiple planar reconstruction with multislice spiral CT in diagnosis of bronchial foreign bodies

Objective To evaluate the muhiple planar reconstruction（MPR） with muhisliee spiral CT（MSCT） in the diagnosis of bronchial foreign bodies. Methods One hundred and eighty patients suspected of bronchial foreign bodies and 6 patients with spontaneous subeutaneous emphysema or pneumothorax were scanned by MSCT and then the images were reconstructed by MPR . The MPR images were compared to what was seen under the stiff bronchoscope, whose value was analyzed later. Results Among the 180 patients, 165 showed foreign bodies by MPR and 163 were certi- fied by bronchoscopy. Fifteen of the 180 patients and the 6 patients with spontaneous subcutaneous emphysema or pneumothorax showed no foreign bodies by MPR and they all healed ＇after the conservative treatment. The diagnostic sensitivity, specificity, false-positive and false-negative rate of MPR was 98, 8% （ 163/165）, 100% （21/21）, 1.2% （ 2/165 ） and 0 respectively. Conclusions MPR with MSCT was of great value in judging the bronchial foreign bodies. （ Chin J Ophthalmol and Otorhinolaynaol ,2010,10 ：295-297 ）