目的探讨多层螺旋CT(MSCT)对 于鉴别诊断小儿气管异物的诊断价值。方 法 选取我院初步诊断为气道异物的小儿 296例，收集时间2015年1月-2017年2月， 对患儿术前胸部X片、MSCT检查结果进行 回顾性分析，分析儿童气道异物的MSCT影 像学特征，并以手术确诊结果作为金标准 分析MSCT诊断小儿气道异物的临床价值。 结果 经硬质支气管镜检查确诊222例患 儿为气道异物，异物类型主要为植物性 (84.68%)；222例气道异物的分布情况见 表2，主要分布在主气管(6.76%)，左气 管(52.70%)、右气管(39.64%)；X线胸片 诊断气道异物117例，主要表现为肺气肿 (43.24%)；MSCT诊断气道异物209例，主 要表现为肺气肿(62.61%)、局限性阻塞 (55.86%）、纵隔移位(39.19%)；X线胸片 诊断气道异物的灵敏度为44.14%、特异 度为74.32%、漏诊率为55.86%、误诊率 为25.68%；MSCT诊断气道异物的灵敏度 为90.99%、特异度为90.54%、漏诊率为 9.01%、误诊率为9.46%。结论 MSCT对于 鉴别诊断小儿气管异物具有较高的灵敏度 和特异度，对于术前明确诊断具有重要价 值。

Objective To investigate the diagnostic value of multi-slice spiral CT (MSCT) in differential diagnosis of tracheobronchial foreign bodies in children. Methods A total of 296 cases of primary airway foreign bodies in our hospital were selected from January 2015 to February 2017. The results of preoperative chest X and MSCT examination were analyzed retrospectively. The MSCT imaging features of children's airway foreign bodies were analyzed, and the clinical value of the diagnosis of MSCT in the diagnosis of children's airway foreign body by surgical diagnosis was analyzed. Results The rigid bronchoscopy confirmed 222 cases of children with airway foreign body, foreign body type is mainly plant (84.68%). 222 cases of distribution of airway foreign bodies in Table 2, mainly distributed in the left and right trachea trachea (52.70%) (39.64%); X-ray diagnosis of airway foreign bodies in 117 cases, the main manifestations of emphysema (43.24% MSCT), diagnosis of airway foreign bodies in 209 cases, mainly for emphysema (62.61%), local obstructive (55.86%) and mediastinal shift (39.19%), the sensitivity of X-ray diagnosis of airway foreign body was 44.14%, the specificity was 74.32%, the misdiagnosis rate was 55.86%, the misdiagnosis rate was 25.68%; the sensitivity of MSCT for the diagnosis of airway foreign body 90.99%, the specificity was 90.54%, the misdiagnosis rate was 9.01%, the misdiagnosis rate was 9.46%. Conclusion MSCT has high sensitivity and specificity in the differential diagnosis of tracheal foreign bodies in children, and has important value for the definite diagnosis before operation.