支气管镜与多层螺旋CT在婴儿先天性呼吸系统发育异常中诊断价值的比较

Diagnostic values of bronchoscopy and multi-slice spiral CT for congenital dysplasia of the respiratory system in infants：a comparative study

摘要:

目的 比较支气管镜与多层螺旋CT在婴儿先天性呼吸系统发育异常中的诊断价值。方法 对行支气管镜或/和多层螺旋CT检查,诊断为先天性呼吸系统发育异常的319例患儿(年龄≤1岁)的临床资料、支气管镜结果、CT检查结果等进行分析。结果 319例患儿中,先天性呼吸系统发育异常476例次,包括原发性呼吸系统发育异常392例次和外压性呼吸系统发育异常84例次。392例次原发性呼吸系统发育异常中,支气管镜确诊225例次(57.4%),高于多层螺旋CT(167例次,42.6%)。支气管镜与多层螺旋CT诊断先天性呼吸系统发育异常的病因构成差异有统计学意义(P<0.05)。气管支气管软化致原发性呼吸系统发育异常76例次,均通过支气管镜检查确诊。肺组织发育异常致原发性呼吸系统发育异常17例次,均通过多层螺旋CT确诊。外压性呼吸系统异常84例中,多层螺旋CT确诊74例次,支气管镜确诊仅10例次。结论 支气管镜检查较多层螺旋CT更易直观发现原发性呼吸系统发育异常,且对气管支气管软化有确诊价值。多层螺旋CT对肺组织发育异常的诊断价值高于支气管镜。

Abstract:

Objective To investigate and compare the diagnostic values of bronchoscopy and multi-slice spiral computed tomography (CT) for congenital dysplasia of the respiratory system in infants. Methods Analysis was performed on the clinical data, bronchoscopic findings and multi-slice spiral CT findings of 319 infants (≤1 years old) who underwent bronchoscopy and/or multi-slice spiral CT and were diagnosed with congenital dysplasia of the respiratory system. Results A total of 476 cases of congenital dysplasia of the respiratory system were found in the 319 infants, including primary dysplasia of the respiratory system (392 cases) and compressive dysplasia of the respiratory system (84 cases). Of the 392 cases of primary dysplasia of the respiratory system, 225 (57.4%) were diagnosed by bronchoscopy versus 167 (42.6%) by multi-slice spiral CT. There were significant differences in etiological diagnosis between bronchoscopy and multi-slice spiral CT in infants with congenital dysplasia of the respiratory system (P <0.05). All 76 cases of primary dysplasia of the respiratory system caused by tracheobronchomalacia were diagnosed by bronchoscopy and all 17 cases of primary dysplasia of the respiratory system caused by lung tissue dysplasia were diagnosed by multi-slice spiral CT. Of the 84 cases of compressive dysplasia of the respiratory system, 74 cases were diagnosed by multi-slice spiral CT and only 10 cases were diagnosed by bronchoscopy. Conclusions Compared with multi-slice spiral CT, bronchoscopy can detect primary dysplasia of the respiratory system more directly. Bronchoscopy is valuable in the confirmed diagnosis of tracheobronchomalacia. Multi-slice spiral CT has a higher diagnostic value for lung tissue dysplasia than bronchoscopy.