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16层多排螺旋计算机断层扫描虚拟气管支气管镜检查和支气管造影在评估儿童疑似气管支气管狭窄中的价值

Value of virtual tracheobronchoscopy and bronchography from 16-slice multidetector-row spiral computed tomography for assessment of suspected tracheobronchial stenosis in children.

作者信息

Honnef Dagmar, Wildberger Joachim E, Das Marco, Hohl Christian, Mahnken Andreas H, Barker Michael, Günther Rolf W, Staatz Gundula

机构信息

Department of Diagnostic Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany.

出版信息

Eur Radiol. 2006 Aug;16(8):1684-91. doi: 10.1007/s00330-006-0230-5. Epub 2006 Apr 19.

Abstract

PURPOSE

To evaluate the value of dose-reduced 16-slice multidetector-row spiral computed tomography (16-MDCT) using virtual tracheobronchoscopy (VTB) and virtual bronchography (VBG) in children with suspected tracheobronchial stenosis.

MATERIALS AND METHODS

12 children (4 d to 3 years, body weight 1.2 kg to 13.5 kg) with stridor and suspected tracheobronchial stenosis were examined by contrast-enhanced low-dose 16-MDCT. Conventional axial slices, MPRs, VTB, and VBG were calculated. Image findings were correlated with the results of fiberoptic bronchoscopy (12 out of 12) as a gold standard and subsequent surgery (8 out of 12).

RESULTS

VTB and VBG demonstrated the fiberoptic bronchoscopically suspected tracheal stenosis in 11 of 12 children due to vascular compression because of the brachiocephalic trunk (6), a double aortic arch (2), a vascular compression of the left main bronchus (2), and a right aberrant subclavian artery (1). Eleven out of 12 stenoses were correctly depicted by conventional axial slices, MPRs, VTB, and VBG. Dose reduction was 79 to 85.8% compared to a standard adult chest CT.

CONCLUSION

Dose-reduced 16-MDCT with the use of VTB and VBG is effective for the evaluation of tracheobronchial stenosis in children and correlates well with fiberoptic bronchoscopy.

摘要

目的

评估采用虚拟气管镜检查(VTB)和虚拟支气管造影(VBG)的低剂量16层螺旋计算机断层扫描(16-MDCT)在疑似气管支气管狭窄儿童中的应用价值。

材料与方法

对12例有喘鸣且疑似气管支气管狭窄的儿童(年龄4天至3岁,体重1.2千克至13.5千克)进行对比增强低剂量16-MDCT检查。计算常规轴位图像、多平面重建(MPR)、VTB和VBG。将图像结果与作为金标准的纤维支气管镜检查结果(12例均做)及后续手术结果(12例中的8例)进行对比。

结果

VTB和VBG显示,12例儿童中有11例因头臂干血管压迫(6例)、双主动脉弓(2例)、左主支气管血管压迫(2例)和右锁骨下动脉异常(1例),经纤维支气管镜检查怀疑存在气管狭窄。12例狭窄中有11例通过常规轴位图像、MPR、VTB和VBG得到正确显示。与标准成人胸部CT相比,剂量降低了79%至85.8%。

结论

采用VTB和VBG的低剂量16-MDCT对评估儿童气管支气管狭窄有效,且与纤维支气管镜检查结果相关性良好。

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