先天性支气管闭锁的多层螺旋CT和X线表现

目的分析先天性支气管闭锁的CT和X线表现，以提高对该病的认识和诊断。方法对11例支气管闭锁患者进行了多层螺旋CT（MSCT）扫描。其中3例经手术证实，6例有支气管镜结果，2例随诊1年以上。肺部常规10mm层厚扫描，在16层螺旋CT机进行1．25mm后处理重组，获得多平面重建（MPR）、最大密度投影（MIP）和最小密度投影（MinIP）图像，记录病变的部位和周围肺组织改变。结果11例病变CT均能显示黏液栓和周围气肿改变，其中3例黏液栓内含气体；x线平片亦能显示全部黏液栓，但仅显示8例气肿改变和2例黏液栓内的气液平。3例支气管闭锁位于左侧，8例位于右侧；发生于段支气管者10例，亚段1例；6例位于肺门旁，5例远离肺门。结论黏液栓和周围肺气肿改变是先天性支气管闭锁的典型表现，在先天性支气管闭锁诊断和鉴别诊断上，多层面螺旋CT能提供比x线平片更多的信息。

Multislice helical CT and chest radiographic findings in congenital bronchial atresia

Objective To present the multislice helical CT (MSCT) and chest radiographic findings of congenital bronchial atresia (CBA) in order to improve the diagnosis of CBA.Methods Eleven patients with CBA, who had histological results in 3 cases, bronchoscopy in 6 cases and more than 1 year follow-up in 2 cases, underwent MSCT with 10 mm slice thickness. 1.25 mm thickness images with 1 mm reconstruction interval were performed on 16-slice helical CT, and multiplanar reconstruction (MPR), maximum intensity projection (MIP) and minimum intensity projection (MinIP) were made at a dedicated workstation. The involved segment of lung, shape of bronchocele and hyperinflation around bronchocele were recorded. Results On CT findings, all 11 patients demonstrated bronchocele and peripheral emphysematous changes which were shown in 8 cases on chest radiographs. An air-fluid level within the bronchocele was seen in 3 cases by MSCT and 2 by chest radiographs. The segmental bronchus was affected in 10 cases and the subsegmental in 1 case. 3 CBAs were in the left and 8 in the right. 6 patients with CBA presented a rounded, branching opacity emanating from the hilum and 5 were seen as a peripheral nodule. Conclusion The presence of a bronchocele and surrouding emphysematous change is the typical radiologic finding of CBA. MSCT can provide more information than X-ray chest radiograph for the diagnosis of CBA.