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Application value of multi－slice spiral CT in diagnosis of tracheobronchial foreign bodies in children

龚瑞  郭玉林  陈勇  朱力  尹姬  王爱军

GONG Rui，GUO Yu－lin，CHEN Yong，ZHU Li，YIN Ji，WANG Ai jun.

Abstract

　　Objective：To determine the application value of multi－slice spiral CT（MSCT） inevaluation of tracheobronchial foreign bodies in children.

　　Methods：CT images of 47 cases withtracheobronchial foreign bodies proved by fiber optic bronchoscope were analyzed retrospectively. The raw data were transmitted to the workstation and the post－processing including multiplanar reconstruction（MPR），CT virtual endoscopy（CTVE）and shaded surface display（SSD）was performed.

　　Results：Among the 47 patients 5 foreign bodies were in trachea，20 in the right main bronchus，12 in the left mainbronchus，3 in the intermediate bronchus，4 in the right inferior lobar branches and 3 in the left inferior lobarbranches. CT features were as follows；complete obstruction of bronchial lumen in 35 cases，partialobstruction of bronchial lumen in 12 cases，obstructive emphysema in 32 cases，and obstructive atelectasis in 15 cases.

　　Conclusion：The combined use of multiple reconstruction methods of MSCT can clearly display tracheobronchial foreign bodies in children and may provide further information for clinical decisions.

　　Key words：Foreign bodies； Trachea； Bronchi； Tomography，X－ray computed

　　儿童气管、支气管异物作为耳鼻咽喉科的1种常见急诊，常引起严重的呼吸道急性梗阻，并可导致阻塞性肺气肿，阻塞性肺炎等严重并发症，早期诊断及时治疗是本病治愈的关键。我院自2002年11月至2004年11月使用多层螺旋CT（MSCT），对50例可疑有儿童气管、支气管异物进行检查，通过对CT横断面图像，及工作站获得的薄层图像分别进行多平面重组（MPR），CT仿真内镜（CTVE）、表面阴影成像（SSD）3种重组方法显示的图像进行分析，以明确异物的部位及性质，然后与经纤维支气管镜及病理证实的47例进行对照，以评价MSCT对儿童气管、支气管异物的临床应用价值。