目的评价128层螺旋CT低剂量 扫描三维重建在儿童先天性中心气道疾 病诊断的应用价值。方法 征得患者父 母同意，对疑诊中心气道疾病的患儿行 多层螺旋CT扫描，将图像数据重建获得 三维重建图像，并将观察结果与纤维支 气管镜检查结果进行对照分析。结果 55 例疑诊中心气道疾病的患儿平均年龄4 岁(1月至11岁，男性40例)，经过纤维 支气管镜检查，气管支气管异常47例， 8例气管支气管软化症。128层螺旋CT低 剂量扫描三维重建观察结果，真阳性者 43例，假阴性者4例，假阳性者1例，真 阴性者7例。CT三维重建与纤维支气管镜 检查结果相对较，显示两者诊断儿童中 心气道疾病无显著性差异(P=0.486)。 CT三维容积重建灵敏度和特异度分别是 91.4%(43/47)和87.5%(7/8)，全部准确 率为90.9%。结论 128层螺旋CT低剂量扫 描发现儿童中心气道疾病有较高的灵敏 度和特异度，诊断儿童中心气道疾病有 重要的应用价值。

Objective To evaluate the application value of three-dimensional (3D) reconstruction at low-dose 128 slice spiral CT in diagnosis of central tracheobronchial diseases of children. Methods Written informed consent was obtained from parents of children. After multislice CT being performed on children with suspected central tracheobronchial diseases, the image data were reconstructed for 3D reconstruction images, then the observed results were compared with those of fibrobronchoscopy for further analysis. Results 55 children with suspected central tracheobronchial diseases were recruited, with the average age being 4 years old (1 month to 11 years old, 40 males). Among them, 47 cases were detected with tracheal bronchus abnormality by fibrobronchoscopy, and 8 cases with tracheobronchomalacia. The results of 3D reconstruction at low-dose 128 slice spiral CT showed that 43 case were true positive, 4 cases false negative, 1 case false positive and 7 cases true negative. There was no significant difference (P=0.486) between 3D reconstruction CT and fibrobronchoscopy in the diagnosis of central tracheobronchial diseases of children. The sensitivity and specificity of 3D reconstruction CT was 91.4% (43/47) and 87.5% (7/8), respectively, and the whole accuracy was 90.9%. Conclusion Low-dose 128 slice spiral CT shows high sensitivity and specificity in detecting central tracheobronchial disease of children, and has important application value in diagnosing central tracheobronchial disease of children.