气管、支气管异物的多层CT诊断价值及限度

摘要

Objective:To evaluate the clinical application of multi-slice CT(MSCT) in the diagnosis of foreign body of trachea or bronchus. Methods:135 cases with foreign body in trachea or bronchus proved by clinic history and bronchoscopic forceps were collected in the study and all cases were examined with MSCT. The post-processing reconstruction included multiple planar reconstruction (MPR). curve multiple planar reconstruction (CMPR), minimum intensity projection ( MinIP) . Results:The foreign body was showed direcrly in 120 cases (88. 9 ％ ). The foreign body was showed indirectly in 9 cases and the total positive rate was (95. 6％). In addition, 6 cases showed false negative image, 135 cases were confirmed with fiberoptic bronchoscopy, in which 131 cases were foreign body in traches and bronchi and 4 cases were purulent sputum in bronchus. Radiation dose of CT was much higher than radiation dose of chest X-ray. Conclusion: MSCT scanning is a significant diagnostic technique in detecting the foreign body in trachca or bronchus, but, we should make use of it carefully.%目的:探讨多层CT在气管、支气管异物诊断中的价值.方法:搜集临床怀疑气管、支气管异物135例.所有病例行多层CT检查,原始图像重建采用多平面重组(MPR)、曲面多平面重组(CMPR)、最小密度投影(MinIP),135患者均进行支气管镜检查.结果:135例患者,129例检查结果为阳性,阳性率(129/135)95.6%,CT直接发现异物120例,占(120/135)88.9%,9例患者通过间接征象判断异物存在,6例患者假阴性.135例患者均经纤维支气管镜检查证实,发现误吸异物131例,4例为支气管内浓痰;另外CT辐射量远大于胸片.结论:多层CT是一种很有价值的诊断气管,支气管异物的检查方法,但亦有其限度,我们应该积极审慎应用多层CT.