小儿先天性气管性支气管的多层螺旋CT诊断

Multislice helical CT diagnosis of the pediatric congenital tracheal bronchus

目的介绍小儿先天性气管性支气管的分类及意义,探讨多层螺旋 CT(MSCT)在该病中的诊断价值。方法回顾性分析43例先天性气管性支气管患儿的计算机 X 线摄影(CR)、MSCT扫描影像资料,MSCT 肺部常规10 mm 层厚扫描,在16层 MSCT 机进行1.25 mm 层厚、1.25 mm 层间隔重组,获得最小密度投影(minIP)、容积重组(VR)、表面遮盖技术(SSD)、仿真支气管内镜(VB)图像,记录病变的部位及与周围组织的关系和伴发异常。结果 43例病变经 CT 后处理技术全部清晰显示,CT 横断面扫描显示37例,CR 仅显示1例;43例中38例有先天性心血管病变,40例为右侧气管性支气管,3例为双侧气管性支气管,共有9例伴随气道狭窄,2例气管插管过深引起右肺上叶节段性肺不张。结论 MSCT 对于诊断先天性气管性支气管,显示气道及其周围伴随组织有良好的价值。

Objective To evaluate the value of multislice helical CT （MSCT） in diagnosis of pediatric congenital tracheal bronchus （CTB）, and to introduce the classification and clinical significance of CTB. Methods All 43 patients were examined with plain chest film and MSCT. All patients were scanned on GE 16-slice lightspeed scanner, using 10 mm coUimation, and reconstructed at 1.25mm intervals and 1.25 mm thickness. Minimum intensity projection （minIP）, Volume-rendered image （VR）, Shadedsurface display（SSD） and Virtual brunchoscopy （VB） were all reconstructed on workstation. The involved tracheal and bronchus, relationship with around organs, and other anomalies were recorded. Results On CT reconstruction images, all 43 patients demonstrated CTB which were found in 37 cases on CT axial scan images and in 1 case on chest radiographs. 38 patients were with congenital heart disease （CHD） ; 40 CTB were on right side, 3 CTB were on both sides; 9 cases were with airway stenosis, 2 cases had symptom with tracheal intubation in a deep location. Conelusious CTB is a rare congenital anomaly in children. MSCT is of value for assessing CTB as wall as the relationship between airway and adjacent structures.