摘要目的:探讨基于低剂量胸部多层螺旋CT（MSCT）三维重建的儿童支气管影像解剖学特点。方法:横断面研究。纳入2021年8月—2023年3月蚌埠市第一人民医院行胸部MSCT检查的患儿200例，其中男116例、女84例，年龄1个月~9岁。200例患儿按年龄分为婴儿期组（年龄<1岁）50例、幼儿期组（1岁≤年龄≤3岁）50例、学龄前期组（3岁<年龄<7岁）60例、学龄期组（7岁≤年龄≤10岁）40例。患儿均行MSCT扫描+三维重建获得两肺支气管树图像，测量气管隆突分叉处左主支气管内径（LBD）和长度（LBL）、右主支气管内径（RBD）和长度（RBL），主气管中轴线分别与左主支气管中轴线的夹角（LA）和右主支气管中轴线的夹角（RA），右主支气管中轴线分别与右上叶支气管中轴线的夹角（RUA）和右下叶支气管中轴线的夹角（RLA），左主支气管中轴线分别与左上叶支气管中轴线的夹角（LUA）和左下叶支气管中轴线的夹角（LLA）。对比不同年龄段组间和不同年龄组中不同性别间各项影像学测量指标的差异。结果:（1）不同年龄组儿童LBD、LBL、RBD、RBL、LUA、RUA随着年龄增加逐渐增大，RLA随着年龄增加逐渐减小，差异均有统计学意义（ P值均<0.05）；LLA、RA随着年龄增加呈先增加后减小的趋势，幼儿期大于婴儿期、学龄前期和学龄期，差异均有统计学意义（ P值均<0.05）；LA在各年龄段组间差异无统计学意义（ P>0.05）。（2）婴儿期男性LBL、RBL、LA大于女性，学龄前期男性LBL大于女性，差异均有统计学意义（ P值均<0.05）；婴儿期、学龄前期其余指标，不同性别间差异均无统计学意义（ P值均>0.05）。而幼儿期、学龄期各项指标不同性别间差异均无统计学意义（ P值均>0.05）。 结论:儿童支气管解剖学结构在不同年龄段、不同性别间存在一定的差异，可为临床儿童呼吸系统疾病的诊断提供影像学参考。

abstractsObjective:This study aimed to explore imaging anatomic features of bronchial in children based on low-dose chest multislice spiral CT(MSCT) three-dimensional reconstruction.Methods:Cross-sectional study. This study included 200 children, including 116 males and 84 females aged 1 month to 9 years old, who underwent MSCT and three-dimensional reconstruction of trachea in Bengbu First People's Hospital from August 2021 to March 2023. The 200 children were classified in a continuous manner based on various ages to generate four groups: 50 infancy (before 1 year old), 50 early childhood (1-3 years old), 60 early school age (3 years old<age<7 years old), 40 school age (7-10 years old) groups. All the children underwent MSCT scan and 3D reconstruction to obtain the images of the two lung bronchial trees. The left main bronchus diameter at the level of tracheal carina (LBD), right main bronchus diameter at the level of tracheal carina (RBD), left main bronchus length at the level of tracheal carina (LBL), right main bronchus length at the level of tracheal carina (RBL), the angle between the middle axis line of the main trachea and that of the left main bronchus (LA), the angle between the middle axis line of the main trachea and that of the right main bronchus (RA), the angle between the middle axis line of the right main bronchus and that of upper lobar bronchus (RUA), the angle between the middle axis line of the right main bronchus and that of inferior lobar bronchus (RLA), the angle between the middle axis line of the left main bronchus and that of the upper lobe bronchus (LUA), the angle between the middle axis line of the left main bronchus and that of the inferior lobar bronchus (LLA) were measured. The differences in various imaging measurement indicators were compared in terms of the various age groups and their genders.Results:(1) In the various age groups, the LBD, LBL, RBD, RBL, LUA, and RUA gradually increased, the RLA gradually decreased with age, and statistically significant differences were observed (all P values< 0.05). The LLA and RA increased first and then decreased with age, with higher values detected in the early-childhood group than the infancy group, and the values for the early-school group and school-age group were less than those of the early childhood group. The difference was statistically significant (all P values < 0.05). No significant difference was observed in the LA of all age groups ( P > 0.05). (2) The males in the infancy group showed greater LBL and RBL than the female. Meanwhile, the males in the preschool age-group manifested a larger LBL than the females, and the differences revealed statistical significance (all P values < 0.05). No significant differences were observed between the genders of the infancy, and preschool-age groups in terms of the other indicators (all P values > 0.05). No significant differences were observed in all indexes between different sexes in the early-childhood and school-age group (all P values > 0.05). Conclusion:Differences are observed in the bronchial anatomical structure of children of various ages and genders can provide imaging references for the diagnosis of respiratory diseases in clinical children.