暴发流行的肺炎衣原体肺炎影像学表现分析  

Imaging Analysis of An Outbreak of Chlamydia Pneumoniae Infection

作　　者：马钦华[1] 陈琦[1] 王建国[1] 胡臣文[1] 曾敏光[1] 邓庆荣[1] 李中华[1] 李主镜[1] 冯锦霞[1] 陈炳祥[1] 

机构地区：[1]深圳市罗湖区人民医院放射科,广东深圳518001

出　　处：《实用放射学杂志》2007年第4期465-468,共4页Journal of Practical Radiology

摘　　要：目的研究肺炎衣原体肺炎暴发流行的胸部影像学特征表现。方法对经过痰和咽试子标本,PCR,MIF检测证实的15例暴发流行的肺炎衣原体肺炎住院患者胸部X线和高分辨CT表现进行分析。结果本组暴发流行的肺炎衣原体肺炎患者均有发热,头痛,全身肌肉酸痛,干咳,声音嘶哑,咽痛等症状。肺部呼吸音减低或细湿啰音4例(26.7%),出现明显肺部影像学表现10例(66.7%)。10例暴发流行的肺炎衣原体肺炎常表现为多发或单发以小叶为中心阴影和腺泡状结节影(100%),病变以两中、下肺叶,外、中带分布;以小叶分布的气腔实变和磨玻璃样阴影(分别为100%和40%)和支气管血管束增厚(90%)。无肺门或纵隔淋巴结增大和胸腔积液。结论暴发流行的肺炎衣原体肺炎具有群体发病,临床和影像学表现有相似的特征,早期CT检查更能真实地反映病变大小、多少和分布范围。Objective To investigate the chest imaging characteristics of an outbreak of the pneumonia caused by chlamydia pneumoniae （ C . pneumoniae ） . Methods A prospective study for C . pneumoniae was presented in 1 5 patients from September 2 0 0 3 . Sputum and pharyngeal swab specimen were obtained and C . pneumoniae were detected by polymerase chain reaction （ PCR ） and by microimmunofluorescence （ MIF ） test. The appearances of the chest X - ray and the high resolution CT were retrospectively analyzed . Results All patients suffered from fever , headache , sore throat , hoarseness , an muscular ache from head to foot , dry cough with a ＂flu - like illnesss＂ . The diminution of respiration and pulmonary thin moist rales were auscultated in 4 cases . The chest imaging manifestations were accounted for （66.7%）. Centrilobular shadow（90% ） , acinar shadow（ 100% ）with the lobar and muhifocal lesions, tendency of the lesions to distribute at the middle and outer layers of lower lobe in bilateral lung（90% ） , air space consolidation and ground - glass attenuation with lobular distribution （ 100% and 40% , respectively ） , and thickening of the broncho - vascular bundle （ 90% ） were found on images. There were uncommon in the hilar or mediastinal lymphadenopathy and the pleural effusion was not developed. Conclusion The colony occurrences, the same clinical and chest manifestations on the whole are the characteristics for an outbreak of pneumonia caused by C. pneumoniae. The size, number and distributions of pulmonary lesions are easily discovered with CT in early stage.

关 键 词：胸部 肺炎衣原体 肺炎 X线摄影术 体层摄影术 X线计算机 

分 类 号：R563.1[医药卫生—呼吸系统] R814.4[医药卫生—内科学]