【摘要】：目的：利用多層螺旋CT（MSCT）三維后處理技術(shù)測(cè)量?jī)和瘹夤芨鲝骄�，獲得兒童氣管影像解剖徑線值，研究?jī)和瘹夤芨鲝骄�與年齡增長(zhǎng)的變化趨勢(shì)，比較MSCT測(cè)量值與尸體測(cè)量值的差異，為兒童氣管解剖的研究積累資料，以期能為臨床行氣管插管、支氣管鏡檢查等氣道介入治療時(shí)選擇器械型號(hào)提供參考數(shù)據(jù)。同時(shí)對(duì)比X線平片測(cè)量結(jié)果，探討利用MSCT研究?jī)和瘹夤軓骄�的應(yīng)用價(jià)值。 材料與方法：回顧性分析從醫(yī)學(xué)影像信息系統(tǒng)（PACS）上獲得的2010年5月～2012年12月之間在我院就診并拍攝胸部CT片的0～12歲長(zhǎng)春地區(qū)兒童3124例。按年齡段分成0～3個(gè)月；4～6個(gè)月；7～9個(gè)月；10～12個(gè)月；1～3歲；4～6歲；7～9歲；10～12歲8個(gè)年齡組。檢查儀器為德國(guó)Siemens16排螺旋CT。在PACS工作站上運(yùn)用MSCT三維后處理技術(shù)獲得重建圖像，在多平面重組重建（MPR）圖像上分別測(cè)量氣管各徑線值并進(jìn)行詳細(xì)記錄，包括胸段氣管長(zhǎng)度、矢狀徑、橫徑和管壁厚度等。將新生兒氣管橫徑和矢狀徑與國(guó)內(nèi)新生兒尸體解剖數(shù)據(jù)進(jìn)行對(duì)比。另外選取120例同時(shí)做胸部X線平片和CT檢查的兒童，在兩種檢查方法所獲得的圖像上分別測(cè)量氣管各徑線值，并對(duì)兩組結(jié)果進(jìn)行對(duì)比。對(duì)所有數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果：在影像學(xué)解剖觀察中，0～12歲各年齡組兒童胸段氣管長(zhǎng)度、橫徑、矢狀徑及氣管管壁厚度的平均值如下：0~3個(gè)月分別為（28.9±4.9）mm、（5.9±0.5）mm、（5.2±0.7）mm、（1.5±0.2）mm；4~6個(gè)月分別為（29.7±4.9）mm（、6.5±0.6）mm（、5.6±0.7）mm（、1.6±0.2）mm；7~9個(gè)月分別為（30.6±4.8）mm、（6.7±0.6）mm、（6.0±0.8）mm、（1.7±0.2）mm；10~12個(gè)月分別為（31.0±4.9）mm、（7.0±0.7）mm、（6.2±0.9）mm、（1.8±0.2）mm；1~3歲分別為（32.5±5.1）mm、（8.1±0.9）mm、（7.3±1.0）mm、（2.0±0.2）mm；4~6歲分別為（36.6±6.8）mm、（9.1±0.9）mm、（8.5±1.3）mm、（2.0±0.2）mm；7~9歲分別為（43.1±8.9）mm、（10.5±1.0）mm、（10.3±1.4）mm、（2.1±0.2）mm；10~12歲分別為（51.2±10.4）mm、（11.8±1.2）mm、（12.3±1.8）mm、（2.4±0.3）mm�？傮w上，兒童氣管各徑線值均隨著年齡段的增加而增大；氣管橫徑大于矢狀徑，但個(gè)體差異較大。在兩性?xún)和校瑲夤芨鲝骄�值存在一定差異，男性?xún)和囟螝夤荛L(zhǎng)度大于女性?xún)和�，但其橫徑和矢狀徑均小于女性?xún)和�；兩性�(xún)和瘹夤芄鼙诤穸却笾孪嗟取SCT測(cè)量新生兒氣管橫徑和矢狀徑均略大于文獻(xiàn)報(bào)道的尸體測(cè)量數(shù)據(jù)。X線片測(cè)量胸段氣管長(zhǎng)度值與MSCT重建圖像測(cè)量值無(wú)明顯差別；X線片測(cè)量氣管橫徑值小于MSCT重建圖像測(cè)量值。 結(jié)論：1.MSCT及其三維后處理技術(shù)對(duì)氣管解剖結(jié)構(gòu)顯示清晰，直觀易懂，測(cè)量方法簡(jiǎn)便無(wú)創(chuàng)，，適合進(jìn)行大樣本量的研究，是研究?jī)和瘹夤芙馄蕪骄�的有效途徑。2.MSCT測(cè)量新生兒氣管內(nèi)徑值略大于尸體測(cè)量數(shù)據(jù)，但更能反映兒童氣管解剖徑線的真實(shí)數(shù)值；3.運(yùn)用MSCT研究各年齡段兒童氣管解剖徑線值有重要的臨床意義。
[Abstract]:Objective: to measure the trachea diameter of children by using multilayer spiral CT (MSCT) 3D post-processing technique, to obtain the anatomic diameter of trachea image of children, to study the change trend of trachea diameter and age growth in children, and to compare the difference between MSCT measurement value and cadaveric measurement value. To accumulate data for the study of trachea anatomy in children, so as to provide reference data for the selection of instruments for clinical tracheal intubation, bronchoscopy and other airway interventional therapy. At the same time, the application value of MSCT in the study of tracheal diameters in children was discussed. Materials and methods: a retrospective analysis of 3124 children aged from 0 to 12 years old in Changchun who were admitted to our hospital from May 2010 to December 2012 to take chest CT films from the medical image information system (PACS) was analyzed. According to the age group, it was divided into 8 age groups: 0 ~ 3 months, 4 ~ 6 months, 7 ~ 9 months, 10 ~ 12 months, 1, 4, 6 years old, 7 ~ 9 years old, 10 ~ 9 years old, 12 years old, 8 age groups. German Siemens16 spiral CT. The reconstructed images were obtained by using MSCT 3D post-processing technique on PACS workstation. The trachea diameter, sagittal diameter, transverse diameter and wall thickness were measured and recorded in detail on the multiplanar reconstructed (MPR) images, including thoracic trachea length, sagittal diameter, transverse diameter and wall thickness. The trachea transverse diameter and sagittal diameter of neonates were compared with the autopsy data of domestic newborns. In addition, 120 children with chest X-ray and CT were selected to measure the trachea diameter values on the images obtained by the two methods, and the results of the two groups were compared. All the data were analyzed statistically. Results: the mean values of thoracic trachea length, transverse diameter, sagittal diameter and trachea wall thickness in children aged 12 years were (28.9 鹵4.9) mm, (5.9 鹵0.5) mm, (5.2 鹵0.7) mm, (1.5 鹵0.2) mm;4~ for 6 months, respectively (29.7 鹵4.9) mm (6.5 鹵0.6) mm (5.6 鹵0.7) mm (1.6 鹵0.2) mm;7~ for 9 months were (30.6 鹵4.8) mm, (6.7 鹵0.6) mm, (6.0 鹵0.8) mm, (1.7 鹵0.2) mm; for 9 months, respectively. 10~12涓湀鍒嗗埆涓

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