胸部CT诊断儿童呼吸道异物的偏差分析  

Deviation Analysis of Chest CT Diagnosis of Respiratory Foreign Body in Children

作　　者：杨素娜[1] 尹德佩[1] YANG Su-na;YIN De-pei(Department of Otolaryngology,Children's Hospital of Soochow University,Suzhou,Jiangsu,215003,China)

机构地区：[1]苏州大学附属儿童医院耳鼻咽喉科,江苏苏州215003

出　　处：《中国血液流变学杂志》2020年第2期250-252,258,共4页Chinese Journal of Hemorheology

摘　　要：目的 分析胸部CT诊断儿童呼吸道异物的偏差原因.方法 回顾2016年8月—2019年8月苏州大学附属儿童医院收治的415例疑诊呼吸道异物的患儿资料,所有患儿均进行胸部CT扫描做出影像学诊断,并进一步进行硬支气管镜检查证实诊断.结果 34例患儿硬支气管镜检查与胸部CT检查结果不符.34例胸部CT判断失误的患儿中,误诊为呼吸道异物30例,漏诊呼吸道异物4例,诊断偏差原因为:普通CT成像质量不高、伪影、扫描位置不合适、CT检查后异物咳出以及CT不够直观等.结论 胸部CT用于诊断儿童呼吸道异物具有较高的准确率,但由于受成像质量、伪影、分辨率等的影响,造成一定比例的偏差.临床医师应重视异物吸入史的重要性和把握硬支气管镜检查的时机,不能过分依赖影像阴性结果,可以减少误诊和漏诊.Objective To analyze the deviation of chest CT in diagnosing foreign body in children.Methods We reviewed clinical data of 415 children suspected to have aspiration foreign body in Children5 s Hospital of Soochow University during the three years from Aug.2016 to Aug.2019.All the children were diagnosed by chest CT scan and confirmed by rigid bronchoscopy.Results The results of rigid bronchoscopy in 34 cases were different from that of chest CT.Among the 34 cases misdiagnosed by chest CT,30 cases were misdiagnosed as aspiration foreign body and 4 cases were missed diagnosis of foreign body.The reasons of diagnostic deviation are as follows:low quality of ordinary CT imaging,artifacts,inappropriate scanning positions,foreign body coughed out after CT examination and CT was not intuitive enough.Conclusion Chest CT has a high accuracy rate in diagnosing foreign body in children,but it is affected by imaging quality,artifacts,resolution and so on,which causes a certain percentage of deviation.Clinicians should pay attention to the importance of the history of foreign body inhalation and grasp the timing of rigid bronchoscopy,and do not rely too much on negative image results,thus we can reduce misdiagnosis and missed diagnosis.

关 键 词：胸部CT 呼吸道异物 误诊 

分 类 号：R76&13[医药卫生—耳鼻咽喉科]