多层螺旋CT诊断小儿支气管异物的临床应用

The clinical application of the multi-slice spiral CT in diagnosis of bronchial foreign bodies in pediatric patients

目的评价多层螺旋CT在诊断小儿支气管异物方面的临床价值。方法回顾性总结经支气管镜检查确诊为支气管异物的40例患儿资料。所有患者均行64层螺旋CT检查,图像后处理用多平面重建(MPR)、曲面重建(CPR)、最小密度投影(MIP)、容积再现(VR)等技术。结果异物位于气管及气管分叉7例,右侧支气管14例,左侧支气管10例,气管-左主支气管2例;坚果类异物16例,豆类4例,玉米3例,果蔬类4例,骨块5例,其他8例。间接伴随征象:肺气肿3例、肺不张1例、肺炎5例、纵隔气肿1例、皮下气肿1例、气胸1例、胸腔积液1例。结论多层螺旋CT诊断小儿支气管异物无创、准确性较高,有很高的实用价值。

Objective To evaluate the clinical value of the multi-slice spiral CT in the diagnosis of bronchial foreign bodies in pediatric patients. Methods Retrospective review of 40 pediatric patients who were diagnosed as bronchial foreign bodies by fiber optic bronchoscopy was reported. All patients underwent 64-slice CT axial scanning and postprocessing reconstruction including multi-planner reformation （MPR）, curved planar reconstruction （CPR）, minimum intensity projection （MinIP）, volume rendering （VR）, etc. Results The foreign bodies of 7 cases happened in trachea and bifurcation of trachea, 14 cases in the right bronchus and 10 cases in the left bronchus, 2 cases in the tracheal and main bronchial; 16 cases of foreign bodies were nuts, 4 cases were beans and 3 cases were corn, 4 cases were fruits and vegetables, 5 cases were bone mass, and 8 cases were the other kinds. Indirect accompanied signs： 3 cases with emphysema, 1 case with ateleetasis, 5 cases with pneumonia, 1 case with mediastinal emphysema, 1 case with subcutaneous emphysema, 1 ease with pneumothorax, I case with pleural effusion. Conclusion The multi-slice spiral CT displays bronchial foreign bodies in pediatric patients accurately and visibly and plays an important role in diagnosis and differential diagnosis of respiratory tract bronchial foreign bodies in pediatric patients.