64排CT在气道支架置入术治疗恶性食管呼吸道瘘中的临床应用

Clinical Application of 64 Row CT in Treatment of Malignant Tracheoesophageal Fistula with the Airway Stent

目的分析总结64排CT在气道支架置入治疗恶性食管呼吸道瘘(MTEF)中的临床应用价值。方法搜集6例MTEF患者临床及影像学资料,回顾性重组原始数据后在CT工作站得到多平面重组(MPR)、容积再现(VR)及仿真内镜(VE)图像。比较CT、口服碘水造影、纤支镜、胃镜显示瘘口的情况及CT测量临床所需相关数据。结果 6例患者共7个瘘口,CT发现6个,纤支镜发现7个,胃镜发现6个,2例行口服碘水造影发现1例,漏诊1例。6例瘘口在MPR、VR、VE上均能显示。运用MPR图像测量瘘口大小、气道最窄处宽径及病灶端正常气道管径,既快捷又精确;结合MPR对病灶端的定位可在VR上测量出需要定制气道支架的长度,既形象又准确。结论64排CT在气道支架置入术治疗MTEF中有很重要的应用价值,可为治疗提供准确的数据,设计出合适的支架,有效封堵瘘口并改善狭窄气道的通气状况。

Objective To analyze and summarize the clinical application of the 64 row CT in treatment of malignant tra- eheoesophageal fistula （MTEF） with the airway stent. Methods The 6 patients with MTEF were selected by a review of the medical records and imaging data. Reconstruction data were formed after retro reconstruction of raw data. Muhiplanar reformation （MPR）, volume rendering （VR）, virtual bronehoseopy （VB） images were obtained. Compare the display of CT and oral iopamidol contrast examination,bronchoscopy, gastroscope and the measure required by clinician by CT. Re- stilts In the 6 patients there are 7 cases of fistula,6 cases were found by CT ,7 cases were found by bronchoscopy, 6 cases were found by gastroscopy ;2 patients were examined by oral iopamidol contrast examination and one case was found, anoth- er case wash＇ t found. 6 cases of fistula were all showed by CT in MPR, VR, VB. In the MPR, measure size of fistula, the narrowest width of airway and normal airway diameter near the lesions rapidly and accurately; combined with positioning of lesions in the MPR, the length of airway stents customized can be measured in the VR visually and exactly. Conclusion 64 row CT in treatment of MTEF with the airway stent is important clinical value. Provide accurate data for the treatment, design a suitable stent, close up fistula effectively and improve the situation of aeration of stenotic trachea.