束胸后16排螺旋CT扫描诊断危重小儿气管支气管异物

Children’s Tracheal Foreign Body Diagnosed by 16 Slice CT Scanning a er Bundled Chest

目的总结束胸后16排螺旋CT扫描在诊断危重小儿气管及支气管异物中的作用。方法对2011年9月-2012年2月4例气管支气管异物危重患儿用自制束缚带束胸后行CT扫描,扫描后所得图像与2009年5月-2011年8月8例既往工作中未行束胸CT扫描危重患儿气管支气管异物图像进行比较(其中1例为同一患儿行常规及束胸后CT检查),并进行图像后处理,包括多平面重建、气管支气管树重建、CT仿真内窥镜;并观察束胸检查前后患儿血氧饱和度(SpO2)变化情况;其中1例进行束胸前后胸廓最大径线比较。结果束胸后CT扫描能明显降低呼吸运动伪影,对气管支气管异物的发现率有明显提高;检查前后患儿SpO2未见明显变化;1例束胸后胸廓最大径线缩小0.8 cm。结论束胸后16层螺旋CT扫描能最大限度的避免呼吸运动伪影,使得气管支气管异物能够快速准确诊断,为后期实施适时治疗提供有效影像资料,进而降低该病的并发症及病死率,并且在束胸检查前后患儿SpO2无明显变化。

Objective To explore the effect of 16 slice CT scanning after bundled chest on critical cases in diagnosing children with tracheal foreign body or bronchial foreign body. Methods Between September 2011 and February 2012, 4 critical children with tracheal foreign were scanned after bundled chest with bandage, and the pictures were compared with the other 8 patients without bundled chest （1 was scanned by two methods）. The images were made by the different image post-processing, including multi planner reconstruction, reconstruction of tracheobronchography, and CT virtual endoscopy. The change of pulse oxygen saturation （SpO2） was observed. We compared the maximum base of thorax after bundled chest. Results Bundled chest reduced teh respiratory movement artifacts, and improved the detection rate of tracheal foreign body. The SpO2 didn＇t change, and the maximum base reduced 0.8 cm in 1 case. Conclusions The 16 slice CT scanning after bundled chest can maximally avoid respiratory movement artifacts so that rapid and accurate diagnosis of tracheal foreign body or bronchial foreign body could be made. It can provide reference for the treatment, reduce the rate of complications and mortality, and the SpO2 doesn＇t change after bundled chest examination.