行纤维支气管镜异物取出术的气道异物患儿胸部DR与螺旋CT诊断价值比较  

Values of digital radiography and multi-slice spiral computerized tomography in the diagnosis of airway foreign bodies in children with bronchoscopic foreign body removal

作　　者：卢培丽 吴瑾秀 张金强 

机构地区：[1]长兴县人民医院放射科,浙江长兴313100 [2]浙医二院放射科

出　　处：《全科医学临床与教育》2017年第2期162-164,169,共4页Clinical Education of General Practice

摘　　要：目的探讨行纤维支气管镜异物取出术的气道异物患儿胸部DR与螺旋CT诊断价值。方法选取80例气道异物病例的临床及影像学资料,对比患儿术前胸部DR片与术后DR片、术前螺旋CT,分析比较患儿术前胸部DR片、螺旋CT显示气道异物定位情况以及透X线异物的直接和间接征象。结果 80例中,71例术前胸部DR片显示了透X线异物的直接征象,主要表现为气管、支气管低密度管状影中断或管壁模糊、管腔不规则、管腔内密度增高影,阳性征象显示率为88.75%;80例术前螺旋CT均显示了透X线异物的直接征象,主要表现为气管、支气管内结节状、柱状、环弧、扁平状或不规则密度增高影充填致管腔狭窄或出现"截断征",阳性征象显示率为100%。两种检查方法在显示异物的间接征象方面无明显差异。在提示异物存在及定位方面,术前胸部DR片78例诊断正确,术前螺旋CT 80例诊断正确。结论胸部DR片能显示绝大部分透X线异物的直接征象,在异物定位方面及诊断透X线气道异物上均具有较高的临床应用价值。对于一般气道异物定位应首选胸部DR片,螺旋CT则适用疑难病例补充应用。Objective To compared the values of digital radiography （DR） and multi-slice spiral computerized tomography （MSCT） in the diagnosis of airway foreign bodies in children with bronchoseopic foreign body removal. Methods Data of eighty children with airway foreign body were collected and analyzed. Preoperative and postoperative DR and MSCT of chest were compared to analyze the direct,indirect imaging findings and localization of intra-tracheobronehial radiolucent foreign body. Results Of the 80 patients,71 patients（88.75%） with preoperative DR showed the direct signs of intra-tracheobronchial radiolucent foreign body which mainly expressed that the interrupted trachea,bronchial low-density tubular shadow or blurred wall,lrregular lumen ,increased shadow of luminal density. Of the 80 patients,80 patients （100%） with preoperation MSCT all showed direct signs of intra- tracheobronchial radiolucent foreign body which mainly expressed that the nodular,columnar,arc,flat of the trachea and bronchial or stenosis or ＂truncation＂ caused by irregular density increased shadow. However,there was no obvious difference in detecting the indirect sign between DR and MSCT. For the ability of localization of foreign body,78 out of 80 patients were found and localized by preoperative chest DR,and 80 out of 80 patients were found and localized by preoperative MSCT. Conclusion The chest DR can reveal direct sign of most intra- traeheabronehial radiolucent foreign body,which have a high application value in the diagnosis and localization of intra-tracheobronchial transluscent foreign body. For the general airway foreign body positioning,the chest DR should he preferentially considered and the MSCT is applicable to difficult eases.

关 键 词：透X线异物 气道 数字X线摄影 螺旋CT 

分 类 号：R768.4[医药卫生—耳鼻咽喉科] R816.96[医药卫生—临床医学]