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目的探讨低剂量多层螺旋CT(MSCT)三维重建在气道发育畸形中诊断价值。方法对临床症状咳嗽、喘息、短期治疗效果欠佳30例患者,行低剂量多层螺旋CT气道多平面重建及容积三维重建,并与纤维支气管镜结果进行对照分析。结果 MSCT显示气管性支气管26例,其中移位型16例、额外多支型9例;支气管桥3例;支气管缺如2例,其中右肺上叶、中叶支气管缺如,右下叶支气管左右分支跨中线1例,右侧支气管完全缺如1例;并发气管狭窄5例,与纤维支气管镜一致,其中双主动脉弓致气管下段及食管狭窄1例。纤维支气管镜下发现气管性支气管20例,其中移位型16例、额外多支型4例;气管狭窄5例,不能窥视远端,诊断不明;喉软化5例。结论低剂量多层螺旋CT多平面重建及容积三维重建显示气道全貌价值肯定,对咳嗽喘息患者寻找病因提供可靠依据,其准确度、敏感度、特异度均高于纤维支气管镜检查。
Objective To investigate the diagnostic value of low-dose multi-slice spiral CT (MSCT) three-dimensional reconstruction in airway deformity. Methods Thirty patients with clinical symptoms of cough, wheezing and short-term treatment were treated with low-dose multi-slice spiral CT airway multiplanar reconstruction and volumetric three-dimensional reconstruction. The results were compared with that of bronchofibroscopy. Results MSCT showed that there were 26 cases of tracheobronchial bronchus, of which 16 cases were transposition, 9 cases were extra bronchialis, 3 cases were bronchial bridge, 2 cases were bronchial absent. Among them, the upper lobe and middle lobe of the right lung were absent, One branch crossed the midline and the right bronchus was completely absent. One case had tracheal stricture in 5 cases, which was the same as that of bronchofiberscopy. One case had a double aortic arch to the trachea and esophageal stenosis. Fiber bronchoscopy found bronchial trachea in 20 cases, of which 16 cases of displacement, extra multi-branch in 4 cases; tracheal stenosis in 5 cases, can not peep at the distal end, the diagnosis is unknown; laryngitis in 5 cases. Conclusions Multiplanar reconstructions of low-dose multislice spiral CT and volumetric three-dimensional reconstruction show the positive value of the whole airway, and provide a reliable basis for finding the cause of cough wheeze. The accuracy, sensitivity and specificity are higher than those of bronchoscopy.