摘要
目的探讨多层螺旋CT(MSCT)平扫及其多重组技术对食管鱼刺异物的显示情况及临床指导价值。资料与方法实验组:取3种不同种类、不同部位的成年鱼刺共90根,分别经设置不同扫描参数(不同层厚和层距)和不同扫描方式(垂直、平行、斜行扫描层面)的MSCT平扫。比较不同扫描参数和方式下MSCT平扫及其多重组技术对鱼刺的检出率。临床组:30例临床高度怀疑食管鱼刺异物者均行食管吞钡棉检查和MSCT平扫,比较两者对鱼刺的检出率,所有病例均经食管镜或手术临床证实。重组方法有多平面重组(MPR)、最大密度投影(MIP)和容积再现(VR)。结果实验组MSCT平扫及多重组图像对3种鱼各部位鱼刺均显示清晰,对鱼刺的检出率为100%,与鱼的种类无关且具有统计学意义。MSCT不同层厚图像鱼刺的检出率有差异,厚层扫描薄层重组的图像所显示出的鱼刺数与MSCT相应同等薄层扫描所得的结果完全一致。3种不同扫描方式所检出鱼刺数结果相同。临床组:经食管镜或手术证实的15例食管鱼刺,食管吞钡棉检查发现6例,检出率40%;MSCT厚层扫描薄层重组结合多重组技术发现15例,检出率为100%,并清楚显示鱼刺的位置、大小及食管损伤周围脓肿情况及范围。3例食管吞钡棉检查及MSCT平扫检查均未发现鱼刺者,食管镜检查或追踪复查亦未发现。结论MSCT对鱼刺的检出率与鱼的种类、扫描方式无关,与层厚有关。MSCT厚层扫描薄层重组结合三维重组技术能提高鱼刺的检出率,并可评价食管损伤及周围脓肿情况和范围,能有效地指导临床选择治疗方案,值得推广。
Objective To evaluate the value of multi-slice spiral CT and 3D reconstruction in the diagnosis of fish bone impaction in the esophagus. Materials and Methods Experimental group ： MSCT with different scan parameters （ different thickness and interval） and types （perpendicular, parallel and oblique to scan planar） were performed in 90 fish bones with three different species. The number and rate of fish bone with different parameters and types were compared using thin-slice axial images combined with 3D reconstructions images. Clinical group： Barium-soaked cotton and MSCT imaging were performed in 30 cases suspicion of fish bones proved by esophageal endoscopy or operation. The number and rate of fish bone impaction in the esophagus were compared. Methods of reconstruction were multiple-planar reformation （ MPR）, maximum intensity projection （MIP） and volume rendering （VR）. Results In experimental group： All the fish bones of three different species were clearly revealed in MSCT, the detection rate of fish bone was 100% which had no relation to fish species. The number of fish bones detected with MSCT and reconstruction images at the smallest section thickness was nearly identical with that of images obtained at different thickness and interval collimation correspondingly. The number of fish bone detected by three different types had no difference but the quality of perpendicular scan planar was the best. In clinical group： 6 cases （40%） were detected by barium-soaked cotton while 15 cases （100%） were detected by MSCT. In addition, the location and size of fish bone in the esophagus and the surrounding and complications of esophagus could he clearly demonstrated in MSCT. 3 cases were negative with both examinations proved by esophageal endoscopy. Conclusion Using a thinner slice reconstructions of a thick-slice scan combined with axial thinner images of MSCT can not only improve the detection rate of fish bone in the esophagus but also evaluate the surrounding and complications o
出处
《临床放射学杂志》
CSCD
北大核心
2007年第11期1143-1146,共4页
Journal of Clinical Radiology
关键词
体层摄影术
X线计算机
食管
异物
鱼刺
Tomography, X-ray computed Esophagus Foreign body Fish bone
