多排螺旋CT对诊断小儿支气管内异物的应用价值

Applied value of multidetector row helical CT for diagnosing intrabronchial foreign bodies in children

目的评价多排螺旋CT(MDCT)及其后处理技术对小儿支气管异物的诊断价值。方法 21例经纤维支气管镜检查证实支气管异物的小儿均经MDCT容积薄层扫描,多平面重建(MPR)和最小密度投影(MinIP)技术显示。回顾性分析其CT表现特征,并将轴位CT扫描及多平面重建图像进行对比和统计分析。结果本组病例发现异物位于气管者4例,右主支气管11例,中间段支气管3例,左主支气管3例。轴位CT诊断小儿支气管异物的敏感度、特异度及准确度分别为93%、90%和91%。结合MPR和MinIP成像其敏感度、特异度及准确度分别可达到99%、100%和99%。结论 MDCT及其后处理技术能准确判断异物的位置、大小、形态及其与相应支气管的关系,并可清晰显示伴随病变,具有重要的临床价值。

Objective To evaluate the applied value of multidetector row helical CT（MDCT） with postprocessing techniques for diagnosing intrabronchial foreign bodies（IBFB） in children.Methods Twenty-one pediatric patients with IBFB confirmed by fiber bronchoscope underwent MDCT volume scan and then the source images were transferred into the workstation and postprocessed by multiplanar reconstruction（MPR） and minimum intensity projection（MinIP）.CT findings of all ill children were analyzed retrospectively.CT images acquired from axial scans were compared with reconstruction imagas to perform the statistic analysis.Results Among 21 cases of IBFB,4 cases were found in trachea,11 cases in right main bronchus,3 cases in right middle brochus,and 3 cases in left main bronchus.The sensitivity,specificity and accuracy of axial CT images for detecting IBFBs were 93%,90% and 91%,respectively.Following combined with MPR and MinIP images,these values as mentioned above were raised to 99%,100% and 99%,respectively.Conclusion MDCT with postprocessing techniques can not only accurately detect the site,size and shape of IBFBs or their relationship with neighbor bronchi but can clearly reveal the complications so that it has important value to diagnose and to treat this disease.