MSCT在小儿气管支气管外源性透X线异物中的临床应用

Clinical Application of MSCT in Pediatric Trachea and Bronchus X-ray Foreign Body

目的探讨MSCT在诊断小儿气管支气管外源性透X线异物中的临床应用价值。方法收集2017年3月~2020年2月英山县人民医院收治的小儿气管支气管外源性透X线异物患儿21例,均行MSCT扫描及MPR处理,依据纤维支气管镜术异物取出位置作为判定标准,分析MSCT诊断异物位置及其直接征象与间接征象。结果21例小儿气管支气管外源性透X线异物中,MSCT显示气管异物3例,右主支气管异物6例,左主支气管异物7例,支气管及右主支气管同时存在1例,右肺中叶及下叶支气管、左肺下叶支气管各1例,右主支气管及右肺上叶支气管同时存在1例。MSCT示气管支气管内类圆形、椭圆形、不规则形高密度影,较大异物可导致气道中断。MSCT轴位示双肺肺气肿(2/3),异物同侧阻塞性肺气肿(17/18)、肺不张(1/21)、肺炎(7/21),纵隔对侧移位(4/21),纵隔同侧移位(1/21)。MSCT显示气管支气管异物的位置与纤维支气管镜结果一致,MSCT正确诊断21例,准确率为100.00%(21/21)。结论MSCT及MPR在小儿气管支气管外源性透X线异物的显示及定位准确性较高。

Objective To explore the clinical value of MSCT in the diagnosis of foreign bodies in children's trachea and bronchus X-ray.Methods A collection of 21 children with exogenous X-ray foreign bodies in the trachea and bronchus admitted to Yingshan County People's Hospital from March 2017 to February 2020 were collected.MSCT scanning and MPR were performed.According to the location of the foreign body taken out by the fiberoptic bronchoscopy as the criterion,the location of the foreign body diagnosed by MSCT and its direct and indirect signs were analyzed.Results X-ray foreign bodies in the trachea and bronchi of 21 children,MSCT showed 3 cases of foreign bodies in the trachea,6 cases of foreign bodies in the right main bronchus,7 cases of foreign bodies in the left main bronchus,1 case of both bronchus and right main bronchus.There were 1 case of right middle lobe and lower lobe bronchus,1 case of left lower lobe bronchus,and 1 case of right main bronchus and right upper lobe bronchus.MSCT showed round,elliptical,and irregular high-density shadows in the trachea and bronchi.Large foreign bodies can cause airway interruption.MSCT axial position showed emphysema in both lungs(2/3),ipsilateral obstructive emphysema with foreign body(17/18),atelectasis(1/21),pneumonia(7/21),contralateral displacement of mediastinum(4/21),the mediastinum is displaced on the same side(1/21).MSCT showed that the location of the foreign body in the trachea and bronchi was consistent with the results of fiberoptic bronchoscopy.MSCT correctly diagnosed 21 cases with an accuracy rate of 100.00%(21/21).Conclusion MSCT and MPR are more accurate in the display and location of X-ray foreign bodies in children's trachea and bronchus.