儿童CT仿真支气管镜的临床应用研究  

CT virtual bronchoscopy in children: clinical application

作　　者：邵剑波[1] 胡道予[2] 夏黎明[2] 王承缘[2] 

机构地区：[1]武汉市儿童医院CT.MRI室,430016 [2]华中科技大学同济医学院附属同济医院放射科

出　　处：《中华放射学杂志》2002年第6期537-540,共4页Chinese Journal of Radiology

摘　　要：目的　探讨儿童CT仿真支气管镜 (CTVB)检查成像技术的特点 ,小儿气道及其病变的CTVB表现、应用价值和限度 ,并与纤维支气管镜 (FOB)所见进行对比分析。方法　利用GEHispeed螺旋CT对 113例临床疑为气管、支气管腔内疾病的患儿胸部进行容积扫描 ,将其中经纤维支气管镜手术和病理证实的 4 5例重建图像数据采用导航 (Navigator)软件进行三维重建 ,形成CTVB图像。结果　 4 5例中 ,CTVB可 10 0 %显示Ⅰ～Ⅲ级支气管 ,对于Ⅳ～Ⅴ级支气管的显示率分别为 4 6 7%和13 3%。FOB仅能显示Ⅰ～Ⅲ级支气管 ,Ⅲ级支气管的显示率为 6 2 2 %。CTVB发现狭窄 34例 ,闭塞 11例 ,占位 16例。除 3例透X线异物和 2例炎性栓子误诊为肿块外 ,其他与FOB检查结果基本相符。结论　CTVB是对CT常规检查方法的重要补充 ,它可弥补FOB的不足。但不能作为独立的诊断依据 ,必须结合CT原始图像或重建图像进行综合分析。Objective To discuss the technique′s characteristics, manifestation, clinical application, and limit in normal and abnormal pediatric airway by using CTVB (CT virtual bronchoscopy) in comparison with FOB (fiberoptic bronchoscopy). Methods Spiral scans were performed by a GE Hispeed spiral scanner in 113 pediatric chests The reformed images of 45 patients were transported to a workstation by which 3 D reconstructions were performed with a software named Navigator and CTVB was generated Results Bronchi were manifested 100% in grades Ⅰ-Ⅲ, 46 7% and 13 3% were revealed in grade Ⅳ and V with CTVB, respectively FOB can only enter grade Ⅰ-Ⅲ bronchi, only 62 2% of the lobar bronchi can be manifested by FOB The findings of CTVB were stenosis ( n =34), occlusion ( n =11), and mass ( n =16) Only 3 radiotransparent foreign bodies and 2 inflammatory emboli were misdiagnosed as tumors, the rest was consistent with FOB Conclusion CTVB is an important supplement to conventional CT, CTVB can detect intraluminal space occupying lesions and occlusions or stenosises caused by all kinds of causes,but lack specificity CTVB can fly through the occlusions or stenosises of the lumen and enter the distal bronchi, thus can make up for the disadvantages of FOB It can′t make the diagnosis independently and must join together the CT primitive the diagram resemble or rebuild the diagram resemble proceeds to synthesize the analysis

关 键 词：CT仿真支气管镜 临床应用 X线计算机体层摄影术 气管异物 气管疾病 支气管疾病 支气管镜检查 儿童 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]