容积螺旋穿梭技术诊断儿童先天性心脏病伴气管软化

发布时间：2018-05-05 09:58

本文选题：先天性心脏病 + 气管软化　；参考：《第二军医大学学报》2017年02期

【摘要】：目的探讨容积螺旋穿梭技术(VHS)在先天性心脏病伴气管软化诊断中的价值。方法回顾性分析上海交通大学医学院附属上海儿童医学中心2014年10月至2016年8月同时行纤维支气管镜和VHS CT增强扫描的26例患儿临床资料,男16例,女10例。按照纤维支气管镜结果将患儿分为气管软化组(n=7)和非气管软化组(n=19)。通过容积重建、最大密度投影重建技术观察评估心内结构、心外大血管解剖,利用最小密度投影技术观察评估气管支气管树解剖结构。利用Mimics 17.0软件对各患儿不同呼吸期相的CT图像进行自动气管分割并测量不同呼吸期相的气管横截面积。以纤维支气管镜及手术结果为金标准,计算VHS CT增强在先天性心脏病的诊断准确性和气管软化的诊断敏感度、特异度和准确度。结果气管软化组气管塌陷面积百分比与非气管软化组的气管塌陷面积百分比差异有统计学意义(34.23%~74.95%vs 13.73%~78.87%,P=0.02)。VHS CT增强在诊断气管软化的敏感度、特异度和准确度分别为85.71%(6/7)、84.21%(16/19)和84.62%(22/26),而在先天性心脏病诊断中心内结构和心外大血管结构的准确度分别是91.67%(11/12)和100%(12/12)。结论 VHS CT作为一种新的扫描方式,一次扫描可同时评估先天性心脏病和气管软化情况,可以作为一种一站式诊断先天性心脏病伴气管软化的检查方法。
[Abstract]:Objective to evaluate the value of volumetric spiral shuttle technique (VHS) in the diagnosis of congenital heart disease with tracheomalacia. Methods from October 2014 to August 2016, 26 children (16 males and 10 females) with bronchofiberscope and VHS CT enhanced scanning were retrospectively analyzed in Shanghai Children's Medical Center, affiliated to Shanghai Jiaotong University Medical College. According to the results of fiberoptic bronchoscopy, the children were divided into tracheomalacia group (n = 7) and non tracheomalacia group (n = 19). The intracardiac structure was observed and evaluated by volume reconstruction and maximum density projection technique. The anatomical structure of tracheobronchial tree was evaluated by minimal density projection technique. Mimics 17.0 software was used to segment the trachea and measure the trachea cross-sectional area in different respiratory phases. The diagnostic accuracy of VHS CT in congenital heart disease and the diagnostic sensitivity specificity and accuracy of tracheomalacia were calculated according to fiberoptic bronchoscopy and surgical results. Results there was significant difference in the percentage of trachea collapse area between the tracheomalacia group and the non-tracheomalacia group. There was a significant difference in the percentage of trachea collapse area between the tracheomalacia group and the non-tracheomalacia group. The specificity and accuracy were 85.71 / 84.21 / 16 / 19 and 84.62 / 22 / 26, respectively, and the accuracy of the structure in the diagnosis center for congenital heart disease and the extracardiac macrovascular structure were 91.67 / 11 / 12 and 100 / 12, respectively. Conclusion as a new scanning method, VHS CT can be used to evaluate both congenital heart disease and tracheomalacia at the same time, and can be used as a one-stop method for diagnosing congenital heart disease with tracheomalacia.
【作者单位】：上海交通大学医学院附属上海儿童医学中心影像诊断中心;上海交通大学医学院附属上海儿童医学中心呼吸科;通用电气医疗集团CT影像研究中心;
【分类号】：R725.411

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