CT多种重建技术的联合应用在诊断儿童呼吸道异物中的临床价值  

Clinical value of combined application of CT multiple reconstruction techniques in the diagnosis of respiratory tract in children

作　　者：徐海东[1] 张玉琴[1] 董海波[1] 朱海东[1] 王洁[1] 

机构地区：[1]浙江省宁波市医疗中心李惠利医院放射科,浙江宁波315041

出　　处：《医学影像学杂志》2016年第7期1226-1229,共4页Journal of Medical Imaging

摘　　要：目的探讨多层CT联合多种气道重建技术在呼吸道异物定性和定位中应用,提高CT在呼吸道异物的早期诊断并辅助治疗的价值。方法搜集96例经支气管镜或手术证实为呼吸道异物的患儿96例,所有患儿治疗前进行呼吸道的CT扫描和多种重建。通过CT表现回顾性分析所有患儿异物的性质和具体位置。结果上呼吸异物9例,主气管异物16例,气管分叉处5例,右支气管异物41例,左支气管异物25例。内源性异物10例,外源性异物86例(其中植物性异物67例,动物性异物9例,金属性异物4例,化学性异物6例),CT对异物的诊断与临床确诊具有一定的一致性(Kappa值为0.696),其中CT对金属性异物和动物性异物的诊断准确性较高,分别为99.0%和96.9%。并发支气管管壁增厚的有19例,肺气肿33例,肺不张11例,肺部感染26例。71例经支气管镜取异物,经CT重建后测量的异物距离口咽的距离与支气管镜进镜的距离相近,且差异不具有统计学意义(P=0.784,t=-8.506))。结论 CT对异物的检出价值较高,多种后处理技术的联合应用可从多方位观察异物的形态和大小,并可对异物的具体距离进行测量从而有助于异物的取出。Objective To the explore the application of CT with a variety of reconstruction technology in the qualitative and positioning of airway foreign body in children, and to improve the value of CT in the early diagnose diagnosis of airway foreign body and adjuvant therapy. Methods 96 cases proven airway foreign body by bronchoscopy or surgery were checked by CT, and all the images were reconstructed by a variety of reconstruction technology. All the images were analyzed and the foreign bodies were measured, which was compared with bronchoscopy. Results Foreign bodies of 9 cases were located in upper respiratory, those of 16 cases were in Main bronchus, 5 cases were in primary tracheal bifurcation, the right bronchial foreign bodies were in 41 cases, 25 cases were left bronchial foreign bodies. Endogenous foreign bodies were in 10 cases, 86 cases were proven foreign bodies （ including 67 cases of vegetable foreign body, foreign body animal in 9 cases, 4 cases of metallic foreign body, foreign body chemistry 6 cases）, there was consistency in the diagnosis between CT and clinical （ Kappa value was 0.696 ） , the accuracy of metallic foreign body and animal accuracy was higher ,which was 99.0% and 96.9% respectively. Conclusion The value of CT in diagnosing the foreign body is high, which can show the shape and size of foreign body with a variety of reconstruction technology. And the distance measured by CT can be contributed to the foreign body removal.

关 键 词：呼吸道异物 儿童 体层摄影术 X线计算机 图像处理 计算机辅助 

分 类 号：R768.13[医药卫生—耳鼻咽喉科]