小儿不典型支气管异物的螺旋CT诊断价值

Diagnostic value of spiral CT in children with atypical bronchial foreign body

目的探讨螺旋CT成像技术在诊断小儿不典型支气管异物中的价值。方法对31例不典型支气管异物的患儿,其中男18例,女13例,年龄10个月~3岁,平均1岁3月,均无明确异物吸入史,采用128层螺旋CT进行扫描(层厚0.6mm,电压120kv,电流83mA),并应用图像分析软件进行图像后处理:包括多平面重建(MPR)、曲面重建(CPR)、最小密度投影(MinP)、表面阴影显示(SDD)和CT仿真内窥镜(CTVB)等,以多平面重建为主。结果28例患儿螺旋CT诊断有支气管异物,其中左侧支气管内19例,右侧支气管内9例。均在全麻下行支气管镜检查、取异物术,术中证实均有异物,且异物位置皆与CT检查结果一致,异物均顺利取出。3例CT诊断无异物者,病史较短,均为4天以内,经抗炎等治疗后痊愈。结论螺旋CT是一种无创、安全的检查方法,能直观显示支气管异物的位置、大小、多少及与周围组织的关系,大大提高了术前诊断的准确性,在不典型支气管异物的诊断中有重要价值。

Objective To explore the value of spiral CT imaging in the diagnosis of atypical bronchial foreign bodies in children.Methods This study included 31 cases of atypical foreign bodies in bronchus of children.There were 18 males and 13 females with age ranged from 10 months to 3 years,average 1 year and 3 months.None of them had definite history of inbreathing the foreign bodies.All the patients above were scaned by 128-slice spiral CT,and analysis software for the picture(such as MPR,CPR,MinP,SDD and CTVB)was used after CT scan.Multiplanar reformation(MPR)was the most important one of them.Results Foreign bodies in bronchus were found directly by spiral CT in 28 cases of the 31 cases.The foreign bodies of 19 cases were in left bronchus and the foreign bodies of 9 cases were in right bronchus.The 28 cases were examined under general anesthesia with bronchoscope and all of them were approved that there were foreign bodies in bronchus.The concrete places of the foreign bodies in bronchus were the same as the results of the spiral CT scan.All the foreign bodies in bronchus were taken out smoothly.The disease histories of the other 3 of 31 cases were less than 4 days,and all of them were cured after using antibiotics.Conclusion Spiral CT is a non-invasive and safe method,which can directly display the location,size,number and relationship with surrounding tissues of bronchial foreign bodies.It can greatly improve the accuracy of preoperative diagnosis.It has important value in the diagnosis of atypical bronchial foreign body.