320排CT联合纤支镜对小儿血管发育异常及气管-胆管瘘的诊断价值  

The diagnostic value of fiberoptic bronchoscopy combined with 320 row CT in pediatric cardiopulmonary malformation and tracheobiliary fistula

作　　者：陈雪丽[1] 夏薇[1] 黄洋[1] CHEN Xue-li;XIA Wei;HUANG Yang(Department of Pediatric Respiratory,Hubei Province Maternity and Child Care Hospital,Wuhan 430070,China)

机构地区：[1]湖北省妇幼保健院儿科呼吸科,武汉430070

出　　处：《放射学实践》2018年第4期428-432,共5页Radiologic Practice

摘　　要：目的:探讨320排CT对心肺血管畸形及纤支镜下碘油造影对先天气管-胆管瘘的诊断价值。方法:对5例先天性心肺发育异常患儿的病例资料进行回顾性分析,评估320排CT及纤支镜下X线碘油造影在儿科复杂心肺发育异常中的诊断价值。结果:5例患儿起病均表现为反复发作的肺炎、肺不张,伴有咳嗽、气促和咯血等症状。320排CT联合纤维支气管镜检查诊断动脉导管假性动脉瘤1例,双主动脉弓1例,左肺静脉缺如1例,右肺静脉缺如1例,320排CT未有阳性发现、经纤支镜下碘油造影确诊为先天性气管-胆管瘘1例。结论:320排CT结合纤支镜检查可以诊断先天性心肺血管畸形,对于高度怀疑为气管-胆管瘘的患儿采用纤支镜下X线碘油造影可明确诊断。Objective:To study the diagnostic value of fiberoptic bronchoscopy combined with 320 row CT in pediatric cardiopulmonary malformation and tracheobiliary fistula.Methods:Five cases with congenital airway and cardiovascular malformation in our hospital were included in this study.We retrospectively analyzed the diagnosis and treatment and summarize the application of inspection technology and methods to evaluate the significance of the fiberoptic bronchoscopy and 320 row CT in complex pediatric respiratory diseases.Results:Five cases were clinically characterized by recurrent pneumonia and atelectasis accompanied by cough,shortness of breath,hemoptysis and other symptoms.Onset age:newborn to 5 years.The findings of fiberoptic bronchoscopy combined with 320 row CT:a case of newborn pseudoaneurysm,a case of neonatal double aortic arch,a case of absence of left pulmonary vein,and a case of absence of right pulmonary veins.But a case of 3 years old child was found negative by 320 row CT and was diagnosed as congenital tracheobiliary fistula by fiberoptic bronchoscopy and iodized oil contrast examination.Conclusion:Fiberoptic bronchoscopy combined with 320 row CT can accurately diagnose congenital cardiopulmonary malformation.In addition,some cases with complex airway malformation need fiberoptic bronchoscopy combined with X-ray iodized oil imaging.

关 键 词：体层摄影术 X线计算机 纤维支气管镜 X线碘油造影 假性动脉瘤 双主动脉弓 气管胆管瘘 

分 类 号：R814.42[医药卫生—影像医学与核医学] R725.4[医药卫生—放射医学]