CAJ | 학술논문

目的探讨低剂量多层螺旋CT(MSCT)三维重建对小儿气管支气管异物的诊断价值.方法经纤维支气管镜检查并确诊为气管支气管异物的患儿43例,均行低剂量MSCT三维重建,原始数据传至工作站(西门子),分别进行多层面重组(MPR)、曲面重组(CPR)、最小密度投影(MinIP)、容积再现(VR)、CT仿真内镜(CTVB),并与纤维支气管镜检查结果进行比较.结果以纤维支气管镜检查结果为定位及定性诊断结果.异物位置:气管及气管分叉处6例,右侧支气管23例,左侧支气管14例,MSCT定位诊断与之相符率为100％(43/43).异物性质:坚果类21例,豆类5例,玉米2例,果蔬6例,其他4例,MSCT均定性诊断为中等密度异物,相符率为100％(38/38);骨块5例,MSCT定性诊断为高密度骨性异物,相符率为5/5.43例患儿中,MPR(CPR)显示异物41例(95.3％),CTVB显示异物33例(76.7％),MinIP显示异物34例(79.1％),VR显示异物23例(53.5％),轴位扫描显示异物21例(48.8％).MPR(CPR)显示异物率高于其他几种后处理方法,差异有统计学意义(P＜0.05);CTVB与MinIP显示异物率比较差异无统计学意义(P＞ 0.05),但高于VR和轴位扫描,差异有统计学意义(P＜0.05).结论低剂量MSCT三维重建成像能够满足小儿气管支气管异物的诊断,可准确评估异物大小、位置、形态及肺部并发症,对可疑气管支气管异物的诊断有重要的临床价值.
목적 탐토저제량다층라선CT(MSCT)삼유중건대소인기관지기관이물적진단개치.방법 경섬유지기관경검사병학진위기관지기관이물적환인43례,균행저제량MSCT삼유중건,원시수거전지공작참(서문자),분별진행다층면중조(MPR)、곡면중조(CPR)、최소밀도투영(MinIP)、용적재현(VR)、CT방진내경(CTVB),병여섬유지기관경검사결과진행비교.결과 이섬유지기관경검사결과위정위급정성진단결과.이물위치:기관급기관분차처6례,우측지기관23례,좌측지기관14례,MSCT정위진단여지상부솔위100％(43/43).이물성질:견과류21례,두류5례,옥미2례,과소6례,기타4례,MSCT균정성진단위중등밀도이물,상부솔위100％(38/38);골괴5례,MSCT정성진단위고밀도골성이물,상부솔위5/5.43례환인중,MPR(CPR)현시이물41례(95.3％),CTVB현시이물33례(76.7％),MinIP현시이물34례(79.1％),VR현시이물23례(53.5％),축위소묘현시이물21례(48.8％).MPR(CPR)현시이물솔고우기타궤충후처리방법,차이유통계학의의(P＜0.05);CTVB여MinIP현시이물솔비교차이무통계학의의(P＞ 0.05),단고우VR화축위소묘,차이유통계학의의(P＜0.05).결론 저제량MSCT삼유중건성상능구만족소인기관지기관이물적진단,가준학평고이물대소、위치、형태급폐부병발증,대가의기관지기관이물적진단유중요적림상개치.
Objective To evaluate the value of low dose multilayer spiral CT (MSCT) threedimensional reconstruction in diagnosis of children tracheobronchial foreign body.Methods Forty-three children with tracheobronchial foreign body which was confirmed by fiberoptic bronchoscopy were enrolled,and all of the children underwent low dose MSCT three-dimensional reconstruction.The volume data were reconstructed on work station (Siemens) with the techniques of multiple plane reformation (MPR),curved planar reconstruction (CPR),minimum intensity projection (MinIP),volume rendering (VR),CT virtual bronchoscopy (CTVB),and the results of MSCT were compared with fiberoptic bronchoscopy.Results The fiberoptic bronchoscopy results were used as the localization and qualitative diagnosis results.Locations of the foreign body were trachea and bifurcation of trachea (6 cases),right bronchus (23 cases) and left bronchus (14 cases),and the coincidence rate of localization diagnosis of MSCT was 100％ (43/43).Natures of the foreign body were nuts in 21 cases,beans in 5 cases,corn in 2 cases,fruits and vegetables in 6 cases,and other kinds in 4 cases.Qualitative diagnosis by MSCT was medium density foreign body,and the coincidence rate was 100％ (38/38).Five cases had bone mass,qualitative diagnosis by MSCT was high density bony foreign body,and the coincidence rate was 5/5.In 43 children,MPR (CPR) showed 41 cases (95.3％),CTVB showed 33 cases (76.7％),MinIP showed 34 cases (79.1％),VR showed 23 cases (53.5％),and axial scan showed 21 cases (48.8％).MPR (CPR) in showing foreign body rate was higher than other several postprocessing methods,and there were statistical differences (P ＜ 0.05).There was no statistical difference in the showing of foreign body between CTVB and MinIP (P ＞ 0.05),but CTVB and MinIP were higher than VR and axial scan,and there were statistical differences (P ＜ 0.05).Conclusions Low dose MSCT three-dimensional reconstruction is satisfactory in the diagnosis of children tracheobronchial foreign body.It can accurately evaluate the exact size,location,shape and pulmonary complications of foreign body,thus it plays an important role in the diagnosis of suspicious tracheobronchial foreign body.