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目的评价64排螺旋CT重建技术在小儿气管异物中的应用价值。方法回顾性总结经纤维支气管镜确诊为气管异物62例患儿的临床资料,所有确诊病例先前均行64排螺旋检查并进行多种重建技术显示气管支气管病变,包括多平面重建(MPR)、曲面重建(CPR)、最小密度投影(MinIP)、容积再现(VR)、CT仿真内窥镜。结果 62例患儿中异物位于右侧支气管及远端28例,位于左侧支气管及远端26例,位于气管隆突上方3例,双侧支气管1例,主支气管4例;其中花生22例,葵花籽16例,核桃仁6例,骨块2例,笔头2例,玉米6例,其他8例。6例复诊提示异物残留,并再次行支气管镜取出。间接征象:阻塞性肺气肿58例,阻塞性肺不张8例,支气管扩张5例,纵隔移位32例,纵隔气肿2例,皮下气肿1例,肺间质气肿1例。结论 64排螺旋CT重建技术可准确评价气管支气管异物,是一种快速、准确、无创性的诊断方法,为临床治疗提供丰富的影像学资料,具有较高实用价值。
Objective To evaluate the value of 64-slice spiral CT reconstruction in pediatric tracheal foreign bodies. Methods The clinical data of 62 children diagnosed as bronchial foreign bodies by fiberbronchoscopy were retrospectively reviewed. All diagnosed cases were previously performed 64-slice helical examination and multiple reconstruction techniques were performed to show tracheobronchial lesions including MPR, Reconstruction (CPR), Minip Density, Volume Reproduction (VR), CT Virtual Endoscopy. Results Totally 62 foreign bodies were located in the right bronchus and distal 28 cases, located in the left bronchus and distal 26 cases, located in the top of the trachea in 3 cases, bilateral bronchus in 1 case, the main bronchus in 4 cases; of which 22 cases of peanut 16 cases of sunflower seeds, 6 cases of walnut, 2 cases of bone, 2 cases of written head, 6 cases of corn and 8 cases of the other. Six cases of referral remind foreign body residue, and bronchoscopy again removed. Indirect signs: obstructive pulmonary emphysema in 58 cases, obstructive atelectasis in 8 cases, bronchiectasis in 5 cases, mediastinal shift in 32 cases, mediastinal emphysema in 2 cases, subcutaneous emphysema in 1 case, interstitial emphysema in 1 case. Conclusion 64-slice spiral CT reconstruction can accurately evaluate tracheobronchial foreign body, which is a rapid, accurate and noninvasive diagnostic method. It provides abundant imaging information for clinical treatment, and has high practical value.