64排CT仿真支气管镜诊断呼吸道疾病的临床研究

The Clinical Research of 64 Slices Spiral CT Virtual Bronchoscopy in Respiratory Diseases

目的评价64排CT仿真支气管镜(CTVB)对于呼吸道疾病的临床诊断价值。资料与方法 30例临床初诊呼吸道疾病的患者,均经纤维支气管镜确诊,所有患者均接受64排CT常规横断面扫描,使用随机软件将原始图像数据重组为三维支气管立体图像,分析CTVB对病变的诊断准确性。结果 30例中,肺癌16例,CTVB表现为:支气管管腔内不规则狭窄,管壁不光整;炎症6例,CTVB表现为:管腔狭窄,管壁似水肿样改变;多软骨炎5例,CTVB表现为:支气管管腔狭窄无隆起,管壁尚光滑;气管内异物2例,CTVB表现为:支气管腔内呈完全隆起样阻塞,管壁光滑;正常1例,CTVB表现为:气管、支气管管腔通畅,管壁光滑。与纤维支气管镜结果相比,CTVB在气道广泛狭窄、气道异物、腔外病灶所致的气管形态改变的诊断上与纤维支气管镜高度一致。结论 64排CTVB可以反映气管支气管腔内病变的形态特征及腔外病变所致管腔形态改变,结合横断面CT扫描对呼吸道疾病的临床诊断及治疗具有一定的指导意义。

Objective To assess the diagnostic value of 64 slices CT virtual bronchoscopy（CTVB） in respiratory diseases.Materials and Methods Thirty patients with respiratory diseases diagnosed by bronchoscopy were examined by using 64 slices spiral CT examinations,and the chest images of transverse CT and virtual bronchoscopy were viewed.Results Among the 30 patients,the masses of trachea and bronchial lumen,bronchial stenosis and bronchial wall thickening were found in 16 patients with lung cancer.Six patients with bronchitis showed bronchial lumen narrowing and edema like change of bronchial wall on CTVB.Five patients with polychondritis showed bronchial lumen narrowing and smooth wall without obvious swelling.Two patients with intrabronchial foreign body demonstrated occlusion of bronchial lumen without bronchial wall thickening.One patient with normal CTVB appearance demonstrated smooth bronchial wall without lumen stenosis.The appearance of CTVB was highly consistent with the diagnosis of bronchoscopy.Conclusion 64 slices spiral CTVB could reflect the morphology of respiratory diseases and provide diagnostic reference value for bronchial disease combined with transverse CT.