儿童呼吸道异物的影像诊断

Imaging diagnosis of foreign body in children's airway

目的评价各种影像检查在儿童呼吸道异物中的价值,提高儿童呼吸道异物的诊断水平。方法回顾性分析62例儿童呼吸道异物的影像检查及不同类型不同部分的影像表现。结果声门附近异物8例,6例可见异物的直接征象。主气管异物16例,均可见两肺不同程度的肺气肿,透视下13例可见心脏反常大小,其中的5例可见异物在气管内的上下移动。右支气管异物24例,左支气管异物14例。32例患者可见明确的肺气肿伴纵隔摆动。全部病例最后作了喉镜或支气管镜检查。取出不同种类的异物包括金属类2例,动物骨骼7例,花生26例,各种瓜子19例,水果、蔬菜5例,其他3例。影像诊断正确55例(88.71%),误漏诊7例(11.29%)。结论双能量减影加透视检查,必要时辅以CT冠状位扫描,可显著提高诊断符合率。

Objective To assess the application value of different imaging examination methods in pediatric airway foreign body and to improve the diagnostic level.Methods Imaging examination methods were performed on 62 cases suffered from airway foreign body(AFB)and imaging findings were analyzed according to different examination methods.Results Foreign body was seen directly in 6 of 8 cases with foreign body just below the vocal cord;16 cases with foreign body in trachea,all of them with bilateral emphysema and abnormal heart size was seen in 13 cases under fluroscopy;movement of foreign body could be seen in the trachea in 5 cases.A total of 24 cases with foreign body in right primary bronohia;14 cases with foreign body in left primary bronchia.Thirty-two cases with definitive emphysema in the affected side and mediastinum swing could be seen.All patients were examined with bronchoscopy finally.Foreign body included 2 metallic AFB,7 animal bones AFB,26 peanut AFB,19 kernel AFB,5 fruits or vegetables AFB and 3 other AFB.Correct diagnosis was made in 55 cases(88.71%),false diagnosis were made in 7 cases(11.29%).Conclusion Dual energy subtraction combined with fluoroscopy,CT scan added if necessary,can improve the diagnosis accuracy.