双源CT气道重建在儿童闭塞性细支气管炎诊断中的应用

Dual-source CT reconstruction technique in children with bronchiolitis obliterans

目的 :探讨双源CT(DSCT)结合气道重建技术在诊断小儿闭塞性细支气管炎(BO)中的应用价值。方法 :回顾性分析经临床确诊的25例BO患者,病程均超过6个月,均行DSCT扫描及气道三维重建,分析其病因、临床特点、DSCT特点及气道重建表现。结果:临床表现为不同程度持续性喘息25例(100%)、反复咳嗽21例(84%)、气促16例(64%)、肺部反复湿啰音17例(68%)、唇周发绀2例(8%)。19例明确为呼吸道感染后引起。CT特点:Mosaic灌注不良25例(100%),斑片模糊影15例(60%),肺实变6例(24%),节段性肺不张4例(16%)。气道三维重建表现:支气管壁增厚16例(64%),支气管扩张5例(20%),支气管内痰栓3例(12%)。结论:感染是BO发生的主要原因,DSCT结合气道重建能较好地显示BO患儿肺实质及气管、支气管病变,对BO的诊断具有较高价值。

Objective：To investigate dual-source CT（DSCT） reconstruction technique in children with bronchiolitis obliterans（BO）.Methods：25 cases of clinically diagnosed patients with BO were retrospective analyzed,duration of more than six months,underwent DSCT scan and airway reconstruction,to analyze the etiology,clinical manifestations and DSCT characteristics. Results：19 cases of BO were caused by respiratory infections. Clinical manifestation：25 cases（100%） were persistent wheezing,21 cases（84%） of repeated coughing,16 cases（64%） of shortness of breath,17 cases（68%） of repeated lung wet rales,2 cases（8%） of lip cyanosis week. CT characteristics：25 cases（100%） of Mosaic perfusion,15 cases（60%） of patchy opacities,6 cases（24%） of pulmonary consolidation,4 cases（16%） of segmental atelectasis. 16 cases（64%） of bronchial wall thickening,5 cases（20%） of bronchiectasis,3 cases（12%） of bronchial sputum. Conclusion：BO is caused due to infection,and DSCT and reconstruction have a better display of lung parenchyma and trachea in children with BO. DSCT has a high value in the diagnosis of BO.