128层螺旋CT低剂量扫描三维重建在儿童先天性中心气道疾病诊断中的应用

Application of Low dose Multi-slice CT with Air Way Post-processing Techniques in the Diagnosis of Children Congenital Central Airway Diseases

目的评价128层螺旋CT低剂量扫描三维重建在儿童先天性中心气道疾病诊断的应用价值。方法征得患者父母同意,对疑诊中心气道疾病的患儿行多层螺旋CT扫描,将图像数据重建获得三维重建图像,并将观察结果与纤维支气管镜检查结果进行对照分析。结果 55例疑诊中心气道疾病的患儿平均年龄4岁(1月至11岁,男性40例),经过纤维支气管镜检查,气管支气管异常47例,8例气管支气管软化症。128层螺旋CT低剂量扫描三维重建观察结果,真阳性者43例,假阴性者4例,假阳性者1例,真阴性者7例。CT三维重建与纤维支气管镜检查结果相对较,显示两者诊断儿童中心气道疾病无显著性差异(P=0.486)。CT三维容积重建灵敏度和特异度分别是91.4%(43/47)和87.5%(7/8),全部准确率为90.9%。结论 128层螺旋CT低剂量扫描发现儿童中心气道疾病有较高的灵敏度和特异度,诊断儿童中心气道疾病有重要的应用价值。

Objective To evaluate the application value of three-dimensional （3D） reconstruction at low-dose 128 slice spiral CT in diagnosis of central tracheobronchial diseases of children. Methods Written informed consent was obtained from parents of children. After multislice CT being performed on children with suspected central tracheobronchial diseases, the image data were reconstructed for 3D reconstruction images, then the observed results were compared with those of fibrobronchoscopy for further analysis. Results 55 children with suspected central tracheobronchial diseases were recruited, with the average age being 4 years old （1 month to 11 years old, 40 males）. Among them, 47 cases were detected with tracheal bronchus abnormality by fibrobronchoscopy, and 8 cases with tracheobronchomalacia. The results of 3D reconstruction at low-dose 128 slice spiral CT showed that 43 case were true positive, 4 cases false negative, 1 case false positive and 7 cases true negative. There was no significant difference （P=0.486） between 3D reconstruction CT and fibrobronchoscopy in the diagnosis of central tracheobronchial diseases of children. The sensitivity and specificity of 3D reconstruction CT was 91.4% （43/47） and 87.5% （7/8）, respectively, and the whole accuracy was 90.9%. Conclusion Low-dose 128 slice spiral CT shows high sensitivity and specificity in detecting central tracheobronchial disease of children, and has important application value in diagnosing central tracheobronchial disease of children.