| Objective:When compared with MSCT check in children with bronchial foreign body aspiration, To contrast image quality and radiation dose of the traditional mode of 64 sensation CT and Flash thorax mode of second-generation dual source computed tomography,and to evaluate the diagnostic value of MSCT on children on tracheal or bronchial foreign bodies.Methods:Retrospective analysis were made in 125 cases of infants and young children which aged 10-60 months with bronchial foreign body in our hospital in the past two years, all the patients were examined by MSCT before operation and preoperative diagnostic accordance rate was 100%.Before doing MSCT. in 125 cases,54 cases of chest fluoroscopy, prompt foreign body 50 cases,43 cases done filming examination. 21 cases were diagnosed as bronchial foreign body, the types, position and imaging signs of foreign bodies were recorded simultaneously. According to different inspection methods were randomly divided into A, B. C, D four groups.Group A: the traditional mode of 64 sensation CT tube voltage is 120KV; group B:the second generation dual source CT lung Flash model, the tube voltage was 120KV: group C:the second generation dual source CT lung Flash model, the tube voltage was 100KV; group D:second generation dual source CT lung Flash mode,80KV tube voltage.The images were reconstructed using SAFIRE-3 technology, respectively, image quality evaluation, evaluation of radiation dose.The original data that scaned of four different patterns process to three-dimensional reconstruction of image,then comprehensive use of volume in the present, the minimum density projection, MPR, CTVE and other methods for image quality evaluation.The subjective image quality assessment by two pediatric imaging diagnostic doctors take double blind method to score 5 points;Objective evaluation record in each group, effective mAs, CT scan mode of scanning time length of volume measurement index (CTDlvol), dose product selected (DLP) and interest area ROI, interested in measuring area of CT values, SD, noise calculated signal-to-noise ratio SNR, the SNR= CT value/noise SD, and calculate the effective radiation dose (ED).Results:1. The positive rate of MSCT, chest X-ray and X-ray film respectively was 100% (125/125),88.89%(48/54),48.83%(21/43).The first positive rate of diagnostic accuracy of foreign body is MSCT,the second is fluoroscopy of chest, the last is chest X-ray.2.The 125 foreign body types cases, there are98 cases of plant,11 cases of animal foreign bodies,9 cases of chemical synthesis and mineral utensil in 5 cases, other 2 cases that unknown type.In the Vegetable foreign bodies, there are peanuts that total of 46 cases, melon seeds which accounted for 29 cases, the other type that total of 23 cases.According to position of the foreign body,there are four types,the first is main bronchus that 7 cases, second is left bronchus in 61, the third is right bronchial that 56 cases, the last is bilateral which total of 1 case.The shown of 125 cases of MSCT, includ 67 cases of lung signs including emphysema,52 cases of obstructive pneumonia,36 cases of mediastinal shift, with mediastinal emphysema (3 cases),13 cases of mediastinal bilateral tax, mediastinal or subcutaneous emphysema in 4 cases.3. Aaccording to the two imaging diagnostic physicians subjectivity evaluate four groups of subjective image,the quality scores were 4.14 ±0.36,4.25 ±0.28,4.11±0.37、 4.09±0.42. Between the four groups of data have no statistical significance, P> 0.05;The CT value date between Four groups is-943.67±17.77,-948.34±10.74, -951.20±13.96,-956.91±10.98 respectively,there is no statistical significance between each other, P>0.05;SD size are 33.61±4.43、32.50±4.32、33.60±4.01、35.82±3.76,SNR are 28.77±3.90,29.78±4.11,28.68±3.51,26.85±2.86.There are no statistical significance between each other, P> 0.05.4. The assessment of Radiation:The CTDlvol of four groupsof image were3.29±0.2,1.4±0.16,0.74±0.15,0.33±0.05. DLP of four groups of images were 60.18±0.89,31.43±3.94,15.49±2.04,7.08±0.85,ED of four groups of images were1.57±0.18、0.82±0.10、0.41±0.05、0.20±0.04.Four sets of data between CTDlvol, DLP and ED have signally statistically differences, P< 0.01).Conclusions:1. In the diagnosis of bronchial foreign body imaging examination, MSCT was the highest, and X-ray was higher than normal.MSCT can make 3D reconstruction on the basis of thin layer scanning, in the display of foreign matter has a greater advantage, and can clearly show the bronchial foreign body caused by pulmonary complications;2. The most common types of bronchial foreign body in children are plants, especially peanut and melon seeds;left bronchus foreign body is not necessarily less than the right side.3. The same conditions of 120 kv, Siemens dual-source CT Flash mode from 64 significantly lower layer spiral CT dose, high image quality, short scan time, simplify the inspection process, infants and young children do not need to be calm to complete scan, In the diagnosis of foreign body, dual source CT is better than 64 CT4. Dual-source CT scan, the use of 120 kv,100 kv tube voltage, tube current automatically adjust the scan, using the 80 kv voltage tube with SAFIRE-3 reconstruction technology, image quality can meet the demand of clinical diagnosis, of which 80 kv SAFIRE-3 reconstruction technology dose is 100 kv reduced half, it is worthy of clinical application in the image examination of bronchial foreign body. |
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