儿童慢性肉芽肿病胸部CT表现  

Chest CT manifestations of chronic granulomatous disease in children

作　　者：赵晶[1] 彭芸[1] 贺建新[2] 

机构地区：[1]首都医科大学附属北京儿童医院影像中心,北京100045 [2]首都医科大学附属北京儿童医院儿研所呼吸分解室,北京100045

出　　处：《医学影像学杂志》2012年第3期359-363,共5页Journal of Medical Imaging

基　　金：首都医学发展基金项目(2009-2077);科技重大专项项目(课题)(2011ZX09302-007-01)

摘　　要：目的分析儿童慢性肉芽肿病(CGD)胸部CT的特征性表现。方法搜集我院2004年6月～2009年12月确诊的30例CGD患儿,对其胸部CT及实验室检查进行回顾性分析和总结。结果 30例CGD患儿,发病年龄小于2岁的有23例,大多数患儿以呼吸道感染来诊,CT发现纵隔、腋下淋巴结肿大27例,淋巴结钙化17例,其中卡介苗接种同侧淋巴结钙化14例,肺内斑片、片状实变19例,结节及团块样病变24例。实变及结节内空洞12例,小叶间隔增厚11例,胸膜增厚10例,少量胸腔积液10例,支气管扩张9例。此组患儿实验室检查33次,病原菌明确的21次检查中5次为曲霉菌感染,并与影像学检查吻合,病原菌未明确的12次检查中,影像学提示为曲霉菌感染的占4次。结论 CGD患儿肺内主要表现包括实变、结节、团块、空洞,间质改变常见。结节与团块样改变高度提示曲霉菌感染,尤其在病原菌检查不明确时,CT对提示曲霉菌感染有很大帮助。纵隔、腋下淋巴结肿大、卡介苗接种同侧腋下淋巴结钙化具有一定特异性,能为临床提供有价值的诊断信息。Objective To describe the thoracic CT features of chronic granulomatous disease in children.Methods The chest CT and Laboratory test were retrospectively analyzed and summarized in 30 diagnosed CGD between June 2004 and December 2009.Results Most patients presented with respiratory infections,23 patients were younger than 2 years old.CT discovered mediastinal and/or hilar lymphadenopathy in 27 patients,lymph nodes calcification in 17 patients,including 14 patients with ipsilateral axillary lymph node calcification after BCG vaccine.CT findings also included areas of consolidation in 19 patients,nodules and masses in 24 cases.Cavities in consolidation and nodules were found in 12 patients,interlobular septal thickening in 11 cases,pleural thickening in 10 patients,small amount of pleural effusion in 10 patients,bronchiectasis in 9 patients.These children had a total of 33 tests.5 times were aspergillus infections in 21 clear tests of pathogen review.This result was coincided with CT findings.Imaging tips for aspergillus infections accounted for 4 times in 12 unclear pathogen review.Conclusion Thoracic CT manifestations of chronic granulomatous disease in children include consolidation,nodules,masses and cavities,with interstitial changes in common.Nodules and masses are highly suggestive of aspergillus infection,especially when pathogen tests are not clear,and imagings on the tips of aspergillus infections will be of great help.Mediastinal and/or hilar lymphadenopathy,ipsilateral axillary lymph node calcification after BCG vaccine has certain particularity,which is very useful for clinician to make diagnosis.

关 键 词：儿童 慢性肉芽肿病 胸部 曲霉菌 体层摄影术 X线计算机 

分 类 号：R725.6[医药卫生—儿科] R814.42[医药卫生—临床医学]