多层螺旋CT诊断儿童气管支气管异物

Application of multislice spiral CT in diagnosis of tracheobronchial foreign body

目的探讨多层螺旋CT在儿童气管支气管异物中的应用价值。方法回顾分析我院近2年159例初诊为儿童气管异物的患者,其中155例术前常规行多层螺旋CT扫描,所有病例均在24 h内行支气管镜检查辅助纤维支气管镜检查。并通过分析同期门诊同时行胸部X线和多层螺旋CT检查的35例疑似病例,比较两种检查方法的优越性。结果 155例多层螺旋CT扫描结果中除外2例误诊,1例漏诊外,另外152例的结果与支气管镜检查结果一致,直接显示有异物影149例(96.1%),肺气肿表现128例(82.6%),肺不张表现14例(9.0%),肺炎表现55例(35.5%),纵膈气肿5例(3.2%)。同期门诊中行胸部X线检查的35例疑似病例中,误诊2例,漏诊3例。结论多层螺旋CT优于胸部X线,在儿童气管支气管异物诊断中具有很高的应用价值。

OBJECTIVE To investigate the value of multislice spiral CT（MSCT）in diagnosis of tracheobronchial foreign bodies.METHODS The clinical data of 159 cases with tracheobronchial foreign bodies treated in our department in recent 2 years were retrospectively studied.MSCT were performed in 155 cases.All the cases performed bronchoscopy assisted with fiberoptic bronchoscopy within 24 hours.Thirty five cases were performed chest x-rays and MSCT.RESULTS Among 155 cases with tracheobronchial foreign bodies performed MSCT,2 cases were misdiagnosed,one case was miss diagnosed,and 152 cases were diagnosed correctly.The MSCT showed foreign body image directly in 149 cases（96.1%）,emphysema in 128 cases（82.6%）,atelectasis in 14 cases（9.0%）,pneumonia in 55 cases（35.5%）and mediastinal emphesema in 5 cases（3.2%）.Among 35 cases with doubtful tracheobronchial foreign bodies performed chest x-rays,2 cases were misdiagnosed and 3 cases were miss diagnosed.CONCLUSION The MSCT scanning has more value than chest x-rays in diagnosis of tracheobronchial foreign bodies in children.