Koşucu Polat, Ahmetoğlu Ali, Koramaz Ismail, Orhan Fazil, Ozdemir Oguzhan, Dinç Hasan, Okten Ayşenur, Gümele Halit Reşit
Department of Radiology, Medical School of Karadeniz Technical University, Farabi Hospital, Trabzon 61080, Turkey.
AJR Am J Roentgenol. 2004 Dec;183(6):1771-7. doi: 10.2214/ajr.183.6.01831771.
The purpose of this study was to investigate the potential use of low-tube-current MDCT virtual bronchoscopy for the evaluation of children with suspected foreign body aspiration.
Low-tube-current MDCT was performed in 23 patients (10 girls, 13 boys) with a mean age of 3.3 years (9 months-13 years) with suspicion of foreign body aspiration. Chest radiographs were obtained before CT was performed. MDCT was performed using 25- to 50-mA tube currents. MDCT virtual bronchoscopy images were obtained. Neither sedation nor IV contrast medium was used during CT scanning. All patients underwent endoscopic evaluation within 24 hr after MDCT was performed. MDCT virtual bronchoscopy findings were retrospectively compared with the results of rigid bronchoscopy.
The mean tube current was 35 mA (range, 25-50 mA). Imaging quality was excellent in nine studies (39%), good in 12 studies (52%), and poor in two studies (9%). Motion artifacts were present on several slices in five examinations. In 15 patients, all foreign bodies detected by conventional bronchoscopy were also revealed on MDCT virtual bronchoscopy. The foreign body was in the right main bronchus in six patients, in the bronchus intermedius in one patient, and in the left main bronchus in eight patients. No discordance was found between the two techniques. MDCT revealed hyperaeration of the ipsilateral lung in five patients, atelectasis in five patients, infiltration in three patients, and infiltration and bronchiectasis in two patients; it showed infiltration in four patients and atelectasis in one of eight patients without a foreign body detected. There were no abnormal findings in three patients.
Evaluation of foreign body aspiration of the airway in children can be accomplished by using a low-tube-current MDCT protocol. It may be useful both in showing the exact location of a foreign body before bronchoscopy and in ruling out a foreign body in patients with a low level of suspicion and normal or nonspecific findings on chest radiography.
本研究旨在探讨低管电流多层螺旋CT（MDCT）虚拟支气管镜检查在疑似异物吸入儿童评估中的潜在应用价值。
对23例疑似异物吸入的患者（10例女孩，13例男孩）进行低管电流MDCT检查，这些患者的平均年龄为3.3岁（9个月至13岁）。在CT检查前拍摄胸部X线片。MDCT检查采用25至50毫安的管电流。获取MDCT虚拟支气管镜图像。CT扫描过程中未使用镇静剂和静脉造影剂。所有患者在MDCT检查后24小时内接受了内镜评估。回顾性比较MDCT虚拟支气管镜检查结果与硬质支气管镜检查结果。
平均管电流为35毫安（范围为25至50毫安）。9项研究（39%）的图像质量优秀，12项研究（52%）的图像质量良好，2项研究（9%）的图像质量较差。5次检查中有几片出现运动伪影。在15例患者中，传统支气管镜检查发现的所有异物在MDCT虚拟支气管镜检查中也被发现。异物位于右主支气管6例，中间支气管1例，左主支气管8例。两种检查方法之间未发现不一致之处。MDCT显示5例患者同侧肺过度充气，5例患者肺不张，3例患者有浸润，2例患者有浸润和支气管扩张；在8例未发现异物的患者中，4例有浸润，1例有肺不张。3例患者未发现异常。
采用低管电流MDCT方案可完成儿童气道异物吸入的评估。它在支气管镜检查前显示异物的确切位置以及排除胸部X线片怀疑程度低且结果正常或非特异性的患者的异物方面可能都有用。
