多排螺旋ct评价漏斗胸畸形程度对心脏形态及 - 第三军医大学学报.doc

论著 64层螺旋CT对儿童漏斗胸小气道改变的评价 赵磊磊，何玲*，陈欣，陈建蓉，刘代松（重庆医科大学附属儿童医院放射科，重庆 400014） 摘要 目的 通过观察儿童漏斗胸小气道改变，探讨胸廓畸形程度对小气道改变的影响及64层螺旋CT的价值。方法 搜集2009年-2011年临床确诊漏斗胸并在我科行胸部64层螺旋CT、三维重建检查的患儿183例，测量胸廓的Haller指数（胸廓最凹平面上，胸廓最大横径与胸骨后缘至同水平线胸椎椎体前缘的距离之比），在MPR肺窗上观察小气道改变（小气道壁扩张、增厚，树芽征，空气滞留征，马赛克征），并探讨它们之间的关系。结果 183例漏斗胸患儿以Haller指数为标准分度：轻度54例2.86±0.31、中度22例3.36±0.10、重度107例4.61±1.27。60例患儿有小气道改变，轻、中、重度分别为22.22%（12/54）、22.73%(5/22)、40.19%(43/107)，三组之间有显著的差异性（ P＜0.05）。60例中53例有左肺下叶小气道的改变。结论 64层螺旋CT可准确显示漏斗胸的胸廓畸形程度、小气道改变。随着胸廓凹陷程度的加重，小气道改变也随之增加，二者间存在相关性。 关键词 漏斗胸；体层摄影术，X线计算机；小气道； 中图分类号： R.726.2 R.814.42 文献标识码： The evaluation of small airway changes in pectus excavatum of children with 64-slice computed tomography ZHAO lei-lei, HE ling*, CHEN xin, CHEN jian-rong, LIU dai-song(Department of Radiology, Childrens Hospital of Chongqing Medical University, Chongqing 400014,China) [Abstract] Objective Throngh the retrospective research of small airway changes in pectus excavatum ,we investigate the effect of the degree of sternal depression on it and the value of the 64-slice CT. Methods 64-slice CT and three-dimensional reconstraction features of pectus excavatum proved clinically 183 cases between 2009 and 2011 were retrospectively reviewed. Measure the Haller index on axial CT images of the chest,research the small airway changes on MPR lung-window and analyse the relationship between them. Results Use Haller index as the classification standard: mid-grade :54 cases 2.86±0.31,middle-grade :22cases 3.36 ±0.10, high-grade: 107case 4.61±1.2; 60 cases have small airway changes,the mobidity of the three grades were 22.22%（12/54）、22.73%(5/22)、40.19%(43/107),there were significant differents amony the three grades(P0.05).53cases among them had lobus pulmonis sinister small airway changes. Conclusion The 64-slice CT is a better tool for revealing chest deformity ,cardiac rotation and small airway changes of pectus excavatum .As the degree of chest deformity increasing, morbidities of small air