螺旋CT三维重建在先天性心脏病合并气道狭窄中的应用评价  

Application of spiral CT three-dimensional reconstruction in congenital heart disease with airway stenosis

作　　者：吴主强[1] 曹婷 余杨红[1] 丁山[1] WU Zhuqiang;CAO Ting;YU Yanghong(Department of Radiology,Children's Hospital of Jiangxi Province,Nanchang 330006;Department of Ultrasound,Gao'an People's Hospital,Gaoan 330800,China)

机构地区：[1]江西省儿童医院放射科,南昌330006 [2]江西省高安市人民医院超声科,高安330800

出　　处：《江西医药》2020年第10期1389-1391,1403,共4页Jiangxi Medical Journal

基　　金：江西省卫生计生委科技计划,编号20195575。

摘　　要：目的通过多层螺旋CT及三维重建技术观察气道狭窄的影像学表现,研究气道异常与不同类型的先天性心脏病的相关性。方法回顾性分析我院2018年1月至2020年5月经心脏超声和64排螺旋CT确诊心血管畸形且合并气管支气管狭窄的患者共46例,按照狭窄位置的不同进行分类,分析其相对应的心脏大血管畸形类型。结果46例先心病并发气管支气管狭窄患儿中,按照狭窄部位分类后以Ⅲ型支气管狭窄(29例,63%)最多见,其次为Ⅱ型气管下段狭窄和Ⅳ型气管、支气管两处以上狭窄,均为7例(15%),Ⅰ型气管上段狭窄发生较少(3例,7%)。并发气管支气管狭窄的先心病类型包括非紫绀型、紫绀型、梗阻型及血管环等,其中以非紫绀型导致气管支气管狭窄的发生率(35.6%)最高。复杂型先天性心脏病较非复杂型更容易合并气管支气管狭窄的发生。结论儿童先天性心脏病容易伴发气管支气管狭窄,狭窄部位主要位于主支气管及气管下段,累及两处时狭窄程度更为严重,气管上段狭窄较少,最易导致气管支气管狭窄的是复杂型/非紫绀型先天性心脏病。Objective To investigate the imaging manifestations of tracheal bronchial stenosis through multi-slice CT and to study the relationship of the tracheal bronchial stenosis with congenital heart disease.Methods A total of 46 patients with cardiovascular malformations confirmed by cardiac ultrasound and 64-slice CT in hospital from Jan 2018 to May 2020 were retrospectively analyzed.The patients were classified according to the location of tracheal bronchial stenosis,and the corresponding types of cardiac macrovascular malformations were analyzed.Results 46 cases in children with tracheal bronchial stenosis,all patients were classified according to the narrow parts,including 29 cases(63%)of typeⅢ,typeⅡandⅣhad 7 cases(15%)each,3 cases(7%)of typeⅠ.The types of congenital heart disease accompanied with airway anomalies included congestive heart disease,cyanosis,outlet obstructive constipation and vascular rings.among them,congestive heart disease was the highest incidence(35.6%)of tracheobronchial stenosis.The possibility of complex congenital heart disease was higher to accompany with tracheal bronchial stenosis than uncomplex congenital heart disease.Conclusion Congenital heart disease is easily associated with tracheobronchial stenosis.stenosis mainly exist in the main bronchus and the low part of trachea site.The degree of stenosis involved in the two places is more severity.The complex/non-cyanotic congenital heart disease is the most likely cause of tracheal bronchial stenosis.

关 键 词：X线计算机体层成像 三维重建 先天性心脏病 气道狭窄 

分 类 号：R725.4[医药卫生—儿科]