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目的:通过比较气道支架置入术后多排螺旋CT与气管镜随访检查的结果,评估多排螺旋CT的诊断价值。方法:收集130例(恶性疾病109例、良性疾病21例)行气管或支气管支架置入术患者,在术后3个月或并发症加重时行多排螺旋CT并行三维重建、多平面重建及曲面重建,在(1.2±0.6)天后行气管镜检查。由两名有经验的放射科医师对支架置入位置、形状、管腔的通畅和邻近气道的CT显示进行评估,并与气管镜结果进行比较。采用Kappa一致性检验两位医师的结果。以配对卡方检验判断CT诊断支架并发症的准确性。结果:61(46.9%)例患者的CT结果显示支架未见异常,其中5例显示不符,后者在气管镜检查显示支架内气管肉芽肿形成,管腔的轻微变窄(<25%)。69例(53.1%)支架在CT上显示有异常改变,其中4例诊断肿瘤复发而气管镜证实为肉芽肿,其余65例与气管镜诊断一致。CT在发现支架置入术后局部异常的灵敏度为96.2%,特异性为100%,诊断准确性为93.1%。结论:CT作为一种非侵入性检查,对气管内植入支架相关检查结果准确性高,可在气管支架随访中起重要作用。
Objective: To evaluate the diagnostic value of multislice spiral CT by comparing the results of multislice spiral CT and tracheoscope follow-up after airway stenting. Methods: Thirty patients (109 cases of malignant disease and 21 cases of benign disease) underwent tracheostomy or bronchial stenting were enrolled in this study. Three-dimensional reconstruction and multi-plane reconstruction Reconstruction of the surface, after (1.2 ± 0.6) days of tracheoscopy. Stent placement, shape, lumen patency, and CT findings of adjacent airways were evaluated by two experienced radiologists and compared with bronchoscopy results. The results of two physicians were tested using Kappa’s consistency. Paired chi-square test to determine the accuracy of CT diagnosis of stent complications. RESULTS: CT findings in 61 (46.9%) of the patients showed no abnormalities in the scaffolds, 5 of which showed discrepancies. The latter showed bronchial granuloma in the stent with a slight lumen narrowing (<25%) on bronchoscopy. Sixty-nine (53.1%) stents showed abnormal changes on the CT, with four diagnosed tumors relapsed and a bronchoscopically confirmed granuloma, with the remaining 65 consistent with bronchoscopy. The sensitivity, specificity and specificity of CT were 96.2%, 100% and 93.1% respectively after finding out the local abnormalities after stenting. Conclusion: As a noninvasive examination, CT is highly accurate in detecting endotracheal stent placement and may play an important role in tracheal stent follow-up.