双源CT图像重组技术对先天性气管支气管发育异常的诊断价值  

The diagnostic value of dual-source CT image recombination technique for congenital tracheobronchial dysplasia

作　　者：陈勇 陈恩龙[1] 隋海晶[1] CHEN Yong;CHEN Enlong;SUI Haijing(Department of Radiology,People’s Hospital of Pudong New District,Shanghai 201299,China)

机构地区：[1]上海市浦东新区人民医院放射影像科,201299

出　　处：《河北医药》2021年第5期705-708,共4页Hebei Medical Journal

基　　金：浦东新区卫生系统学科带头人培养计划(编号:PWRd2018-15)。

摘　　要：目的分析双源CT(DSCT)图像重组技术对先天性气管支气管发育异常的诊断价值。方法收集行DSCT检查的先天性气管支气管发育异常患儿64例,根据胚胎学、形态学及病理学将患儿分为3类,包括气管支气管分支异常、气管支气管壁发育异常及食管-气管瘘,结合图像重组技术对患儿气管及支气管的数目、形态、走行、发育变异及合并其他胸内畸形情况进行分析。结果气管支气管分支异常38例(59.38%),包括气管支气管29例、支气管桥4例、支气管分支数目异常3例、支气管开口位置异常2例。气管支气管壁发育异常21例(32.81%),包括气管憩室11例、气管支气管狭窄6例、支气管囊肿4例。食管-气管瘘5例(7.81%)。64例患儿中30例合并其他胸内畸形,占46.88%,包括室间隔缺损10例(15.63%)、食管闭锁5例(7.81%)、动脉导管未闭4例(6.25%)、房间隔缺损4例(6.25%)、肺发育不良3例(4.69%)、肺动脉吊带2例(3.13%)、脊柱畸形1例(1.56%)、支气管动脉-肺循环瘘1例(1.56%)。结论先天性气管支气管发育异常类型较多,常合并其他畸形;DSCT属于无创检查,具有分辨率高、扫描速度快的优点,灵活运用图像重组技术可准确判断气管支气管树及周围组织情况,对合并其他畸形的诊断较纤维支气管镜更具优势。Objective To investigate the diagnostic value of dual-source CT(DSCT)image recombination technique in diagnosis of congenital tracheobronchial dysplasia.Methods A total of 64 children with congenital tracheobronchial dysplasia who underwent DSCT examination were enrolled in the study.According to the embryology,morphology,and pathology,these patients were divided into three categories,including abnormal tracheal bronchus branches,tracheal bronchus wall dysplasia and esophageal-tracheal fistula.The numbers of trachea and bronchi,morphous,development and the other intrathoracic deformity were analyzed by embryology,morphology,pathology combined with image restructuring technique.Results There were 38 cases(59.38%)of abnormality of trachea bronchus branch,including 29 cases of trachea bronchus,4 cases of bronchus bridge,3 cases of abnormality of branch number and 2 cases of abnormality of bronchial opening position.There were 21 cases(32.81%)of abnormality of tracheal bronchial wall development,including 11 cases of tracheal diverticulum,6 cases of tracheal bronchial stenosis,and 4 cases of bronchial cyst.Moreover there were 5cases(7.81%)of esophagotracheal fistula.Among the 64 cases,30 cases(46.88%)were associated with other intrathoracic malformations,including 10 cases(15.63%)of ventricular septal defect,5 cases(7.81%)of esophageal atresia,4 cases(6.25%)of patent ductus arterialis,4 cases(6.25%)of atrial septal defect,3 cases(4.69%)of pulmonary dysplasia,2 cases of pulmonary conjunctiva(3.13%),1 case(1.56%)of spinal malformation,and 1 case(1.56%)of bronchial artery-pulmonary circulation fistula.Conclusion There are many types of congenital tracheal and bronchial dysplasia.DSCT is a non-invasive examination,with the advantages of high resolution and fast scanning speed.The application of image reorganization technique can accurately evaluate the tracheobronchial tree and surrounding tissues,which is superior to fiberoptic bronchoscope in the diagnosis of the other malformations.

关 键 词：气管 支气管 先天发育异常 计算机体层摄影 纤维支气管镜 

分 类 号：R814.42[医药卫生—影像医学与核医学]