目的 探讨多层螺旋CT三维重建技术在婴幼儿(0~3岁)气道异物诊断中的应用价值.方法 回顾性分析197例经临床支气管镜检查确诊为气道异物患儿的影像资料.所有患儿均行64排螺旋CT检查,然后经工作站运用多层面重组、曲面重组和最小密度投影法后处理技术进行三维重建.其中58例患儿同时采用仿真内窥镜技术进行图像处理,比较二者对于异物的检出是否存在统计学差异.结果 除3例患儿异物未能明确诊断考虑为分泌物外,其余194例异物位置大小均可明确显示和诊断,其中喉部1例,主气管8例,气管分叉处2例,右侧支气管102例,左侧支气管77例,左右主支气管均有异物4例.大部分患儿伴有肺气肿、肺炎、肺不张和纵膈皮下积气等气道异物间接征象.三维重建技术和仿真内窥镜技术二者对于异物检出无统计学差异.结论 多层螺旋CT三维重建技术对儿童气道异物的检出准确率非常高且能明确异物位置,属于无创伤性检查,可作为支气管镜异物取出术前的重要辅助检查手段.%Objective This paper aimed to evaluate the application value of the multi-slice spiral CT in the diagnosis of bronchial foreign bodies in pediatric patients aged from 0 to 3 years old. Methods Retrospectively analyzed the imaging data of 197 pediatric patients who were diagnosed as bronchial foreign bodies by fiber optic bronchoscopy. All patients underwent 64-slice CT axial scanning and post-processed reconstruction including multi-planner reformation, curved planar reconstruction and minimum intensity projection. 58 cases of children's images were processed by CT virtual endoscopy, and evaluated if there were significant statistical difference between the two groups. Results Except 3 patients was misdiagnosed, the remaining 194 cases of foreign body size could be clearly displayed and diagnosed, 1 case happened in throat, 8 cases in trachea, 2 cases in bifurcation of trachea, 102 cases in the right bronchus, 77 cases in the left bronchus and 4 cases in both the right and left bronchus. Indirect accompanied signs were happened in the majority of patients, such as emphysema, pneumonia, atelectasis, mediastinal emphysema and subcutaneous emphysema. There was no significant difference between the two groups. Conclusion The multi-slice spiral CT is non-invasive examination and displays bronchial foreign bodies in pediatric patients accurately and visibly, so it can be used as the most important examination before fiber optic bronchoscopy.
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