Yunus Mahira
Al-Noor Hopital Makkah, KSA.
J Pak Med Assoc. 2012 Nov;62(11):1154-60.
To study the use of helical computed tomography 2-D and 3-D images, and virtual endoscopy in the evaluation of airway disease in neonates, infants and children and its value in lesion detection, characterisation and extension.
Conducted at Al-Noor Hospital, Makkah, Saudi Arabia, from January 1 to June 30, 2006, the study comprised of 40 patients with strider, having various causes of airway obstruction. They were examined by helical CT scan with 2-D and 3-D reconstructions and virtual endoscopy. The level and characterisation of lesions were carried out and results were compared with actual endoscopic findings. Conventional endoscopy was chosen as the gold standard, and the evaluation of endoscopy was done in terms of sensitivity and specificity of the procedure. For statistical purposes, SPSS version 10 was used.
All CT methods detected airway stenosis or obstruction. Accuracy was 98% (n=40) for virtual endoscopy, 96% (n=48) for 3-D external rendering, 90% (n=45) for multiplanar reconstructions and 86% (n=43) for axial images. Comparing the results of 3-D internal and external volume rendering images with conventional endoscopy for detection and grading of stenosis were closer than with 2-D minimum intensity multiplanar reconstruction and axial CT slices. Even high-grade stenosis could be evaluated with virtual endoscope through which conventional endoscope cannot be passed. A case of 4-year-old patient with tracheomalacia could not be diagnosed by helical CT scan and virtual bronchoscopy which was diagriosed on conventional endoscopy and needed CT scan in inspiration and expiration.
Virtual endoscopy [VE] enabled better assessment of stenosis compared to the reading of 3-D external rendering, 2-D multiplanar reconstruction [MPR] or axial slices. It can replace conventional endoscopy in the assessment of airway disease without any additional risk.
研究螺旋计算机断层扫描二维和三维图像以及虚拟内镜在评估新生儿、婴儿和儿童气道疾病中的应用及其在病变检测、特征描述和范围确定方面的价值。
该研究于2006年1月1日至6月30日在沙特阿拉伯麦加的努尔医院进行，纳入了40例因各种原因导致气道阻塞而出现喘鸣的患者。对他们进行了螺旋CT扫描，并进行二维和三维重建以及虚拟内镜检查。确定病变的位置和特征，并将结果与实际内镜检查结果进行比较。选择传统内镜检查作为金标准，并根据该检查方法的敏感性和特异性进行评估。为进行统计分析，使用了SPSS 10版软件。
所有CT方法均检测到气道狭窄或阻塞。虚拟内镜检查的准确率为98%（n = 40），三维外部重建为96%（n = 48），多平面重建为90%（n = 45），轴位图像为86%（n = 43）。在狭窄的检测和分级方面，将三维内部和外部容积再现图像的结果与传统内镜检查进行比较，比二维最小强度多平面重建和轴位CT切片更接近。即使是传统内镜无法通过的高级别狭窄，也可通过虚拟内镜进行评估。一名4岁患有气管软化症的患者，螺旋CT扫描和虚拟支气管镜检查未能诊断，而传统内镜检查确诊，且该病例需要在吸气和呼气时进行CT扫描。
与三维外部重建、二维多平面重建（MPR）或轴位切片相比，虚拟内镜（VE）能够更好地评估狭窄情况。在气道疾病评估中，它可以替代传统内镜检查，且无任何额外风险。
