56例儿童重症腺病毒肺炎的胸部CT影像表现特点  

Chest CT features of severe adenovirus pneumonia in 56 children

作　　者：李燕[1] 何玲[1] 陈欣[1] 刘先凡[1] 刘代松[1] 赵磊磊[1] 刘成军[2] 刘恩梅[3] 宋燕[3] 

机构地区：[1]重庆医科大学附属儿童医院放射科,重庆400014 [2]重庆医科大学附属儿童医院重症监护室,重庆400014 [3]重庆医科大学附属儿童医院呼吸科,重庆400014

出　　处：《第三军医大学学报》2012年第6期558-560,共3页Journal of Third Military Medical University

基　　金：重庆市自然科学基金(CSTC2010BB5379)~~

摘　　要：目的总结56例儿童重症腺病毒肺炎的胸部CT影像表现特点,提高该病的影像诊断能力。方法选择本院2010年4月至2011年4月经临床确诊的儿童重症腺病毒肺炎56例,男性43例,女性13例,年龄1个月至7岁,回顾性分析其临床和胸部CT表现特点。结果 56例患儿鼻咽部脱落细胞用免疫荧光法检测腺病毒抗原均阳性,临床均符合WHO儿童急性呼吸道感染防治规划中的重症肺炎诊断标准。胸部CT表现:肺实变56例,其中双侧受累45例,向心分布28例,团簇状影43例,胸膜病变28例,淋巴结肿大16例。气胸2例,纵隔气肿2例。在治疗过程中或随访中出现小气道改变40例。结论儿童重症腺病毒肺炎以多发团簇状肺实变为主要改变,可伴胸膜病变、气胸、纵隔气肿等肺外表现,如出现小气道改变应警惕闭塞性细支气管炎的发生。Objective To summarize the chest CT features of severe adenovirus pneumonia in 56 children in order to enhance the diagnostic ability.Methods The clinical and chest CT manifestations of 56 children with diagnosed severe adenovirus pneumonia who were admitted in our hospital from April 2010 to April 2011 were retrospectively analyzed.Results The immunofluorescence results showed that the exfoliated nasopharyngeal cells from the 56 children were all adenovirus antigen positive.All the children reached the diagnostic criteria of severe adenovirus pneumonia in the program for the control of acute respiratory infections by WHO.The chest CT manifestations showed that lung consolidation was observed in all the patients,including bilateral involvement in 45 patients,consolidation centripetal distribution in 28 patients,clustered consolidation in 43 patients,pleural lesions in 28 patients,lymph node enlargement in 16 patients,pneumothorax in 2 patients and mediastinal emphysema in 2 patients.Small airway changes were observed in 40 patients during the treatment or follow-up.Conclusion Multiple clustered consolidation,which can be accompanied by pleural lesions,pneumothorax and mediastinal emphysema,is the main manifestation of severe adenovirus pneumonia in children.Doctors should be vigilant against Bronchiolitis obliterans when small airway changes are observed.

关 键 词：儿童 腺病毒肺炎 CT 闭塞性细支气管炎 

分 类 号：R511.8[医药卫生—内科学] R725.631[医药卫生—临床医学]