Haliloglu Mithat, Ciftci Arbay O, Oto Aytekin, Gumus Burcak, Tanyel F Cahit, Senocak Mehmet E, Buyukpamukcu Nebil, Besim Aytekin
Department of Radiology, Hacettepe University Faculty of Medicine, Ankara TR-06100, Turkey.
Eur J Radiol. 2003 Nov;48(2):188-92. doi: 10.1016/S0720-048X(02)00295-4.
Computed tomography (CT) virtual bronchoscopy is a noninvasive technique that provides an internal view of trachea and major bronchi by three-dimensional reconstruction. The aim of this study was to investigate the usefulness of virtual bronchoscopy in the evaluation of suspected foreign body aspiration in children.
Twenty-three children (12 girls, 11 boys) with a mean age of 2.4 years (8 months-14 years) who were admitted to emergency room with a suspicion of foreign body aspiration were included in this study. Chest radiograms, spiral computed tomography scans and virtual bronchoscopy images were obtained. Then, rigid bronchoscopy was performed within 24 h.
CT virtual bronchoscopy and conventional bronchoscopy revealed the location of the foreign body in seven patients. It was in the right main bronchus in four patients, in the right lower lobe bronchus in one patient, and in the left main bronchus in two patients. There was no discordance between two modalities. CT examination revealed hyperaeration of the ipsilateral lung in four patients, hyperaeration of the ipsilateral lung and mediastinal shift in one patient and bronchiectatic changes in one patient. CT detected no additional finding in one patient with a foreign body in the right main bronchus. In 10 of 16 patients without foreign body, CT examination demonstrated atelectasis, infiltration, peribronchial thickening, and paratracheal lymphadenpoathy.
Helical CT scanning with virtual bronchoscopy should be performed in only selected cases with suspected foreign body aspiration. When the chest radiograph is normal and the clinical diagnosis suggests aspirated foreign body, helical CT and virtual bronchoscopy can be considered in order to avoid needless rigid bronchoscopy.
计算机断层扫描（CT）虚拟支气管镜检查是一种通过三维重建提供气管和主要支气管内部视图的无创技术。本研究的目的是探讨虚拟支气管镜检查在评估儿童疑似异物吸入中的实用性。
本研究纳入了23例平均年龄2.4岁（8个月至14岁）因疑似异物吸入入住急诊室的儿童（12例女孩，11例男孩）。获取胸部X线片、螺旋计算机断层扫描和虚拟支气管镜图像。然后，在24小时内进行硬质支气管镜检查。
CT虚拟支气管镜检查和传统支气管镜检查在7例患者中显示了异物的位置。4例位于右主支气管，1例位于右下叶支气管，2例位于左主支气管。两种检查方式之间无不一致之处。CT检查显示4例患者同侧肺过度充气，1例患者同侧肺过度充气并伴有纵隔移位，1例患者有支气管扩张改变。1例右主支气管有异物的患者CT未发现其他异常。在16例无异物的患者中，10例CT检查显示肺不张、浸润、支气管周围增厚和气管旁淋巴结肿大。
仅在选定的疑似异物吸入病例中进行螺旋CT扫描及虚拟支气管镜检查。当胸部X线片正常且临床诊断提示有异物吸入时，可考虑进行螺旋CT和虚拟支气管镜检查以避免不必要的硬质支气管镜检查。
