纤维支气管镜检查与多排螺旋CT在儿童先天性心脏病伴气道病变诊断中的应用比较

A comparison between fiberoptic bronchoscopy and multislice helical CT in the diagnosis of airway anomalies of children with congenital heart diseases

目的探讨纤维支气管镜(纤支镜)检查与胸部多排螺旋CT(MSCT)在儿童先天性心脏病(先心病)伴气道病变诊断的应用价值。方法28例先心病伴气道病变的患儿进行纤支镜和MSCT,分析比较两种方法的差异。结果纤支镜和MSCT均可发现较大气道病变,显示病变类型、管腔形态、病变长度、狭窄程度等。纤支镜还可明确诊断上呼吸道和3级以下支气管病变、气道黏膜病变和病理、病原学诊断,对部分病变可达到治疗效果(如声门网或蹼)。MSCT则可显示气道与周围组织的关系、血管走行以及阻塞远端气道情况。结论纤支镜和MSCT联合应用可较全面的诊断先心病伴气道病变。

Objective To evaluate fiberoptic bronchoscopy （FOB） and multislice helical CT （MSCT） diagnosis of airway anomalies in children with congenital heart diseases. Methods Effectiveness and difference of FOB and MSCT in diagnosis of the airway anomalies were compared in 28 cases with congenital heart diseases. Results Both FOB and MSCT were effective in detecting the large airway anomalies such as lesion type, morphology and severity. FOB was useful in the evaluation of respiratory lesions as well as pathological change and pathogenic organism. In addition, FOB was also applied to treat some diseases such as glottis web during the examination procedure. MSCT had great diagnostic value on airway changes distal to stenosis areas and it was also helpful in determining the relationship between the airway and the surrounding tissue or organs. Conclusion Both FOB and MSCT were the useful technique in the evaluation and diagnosis of airway anomalies among children with congenital heart diseases.