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对比单层冠状位厚块最小密度投影与纤维支气管镜检查在儿童支气管内膜结核气道受压中的应用。

Comparison of single coronal thick-slab minimum intensity projection with flexible bronchoscopy for airway compression in children with lymphobronchial tuberculosis.

机构信息

Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Waikato District Health Board, Waikato Hospital, 183 Pembroke Street, Hamilton 3204, New Zealand.

出版信息

Clin Radiol. 2023 Aug;78(8):576-583. doi: 10.1016/j.crad.2023.03.021. Epub 2023 May 13.

Abstract

AIM

To generate standardised coronal minimum intensity projection (MinIP) computed tomography (CT) reconstructions, and compare these with flexible bronchoscopy in children with lymphobronchial tuberculosis (LBTB).

MATERIALS AND METHODS

Standardised coronal MinIP reconstructions were performed from CT images in children with LBTB and the findings of three readers were compared with the reference standard, flexible bronchoscopy (FB), regarding airway narrowing. Intraluminal lesions, the site of the stenosis, and the degree of stenosis were also evaluated. The length of stenosis was evaluated by CT MinIP only.

RESULTS

Sixty-five children (38 males; 58.5% and 27 females; 41.5%), with ages ranging from 2.5 to 144 months were evaluated. Coronal CT MinIP demonstrated a sensitivity of 96% and specificity of 89% against FB. The most common site of stenosis was the bronchus intermedius (91%), followed by the left main bronchus (85%), the right upper lobe bronchus RUL (66%), and the trachea (60%).

CONCLUSION

Coronal CT MinIP reconstruction is useful in demonstrating airway stenosis in children with lymphobronchial TB, with high sensitivity and specificity. CT MinIP had additional advantages over FB in that it allowed objective measurement of the diameter of stenosis, measurement of the length of stenosis, and evaluation of post-stenotic segments of the airways and lung parenchymal abnormalities.

摘要

目的

生成标准化的冠状最小密度投影(MinIP)计算机断层扫描(CT)重建图像,并将其与儿童淋巴支气管结核(LBTB)的柔性支气管镜检查进行比较。

材料和方法

对 LBTB 患儿的 CT 图像进行标准化的冠状 MinIP 重建,由三位读者对气道狭窄的发现与参考标准(柔性支气管镜检查,FB)进行比较。还评估了管腔内病变、狭窄部位和狭窄程度。仅通过 CT MinIP 评估狭窄的长度。

结果

评估了 65 名年龄在 2.5 至 144 个月之间的儿童(38 名男性,占 58.5%;27 名女性,占 41.5%)。冠状 CT MinIP 对 FB 的敏感度为 96%,特异性为 89%。最常见的狭窄部位是中间支气管(91%),其次是左主支气管(85%)、右上叶支气管(66%)和气管(60%)。

结论

冠状 CT MinIP 重建在显示儿童淋巴支气管结核的气道狭窄方面非常有用,具有较高的敏感度和特异性。与 FB 相比,CT MinIP 具有额外的优势,它可以客观地测量狭窄的直径、狭窄的长度,并评估气道狭窄后的节段和肺实质异常。

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