儿童麻疹肺炎胸部CT影像学特点  

Chest CT imaging features of measles pneumonia in children

作　　者：余小花[1] 何玲[1] 

机构地区：[1]重庆医科大学附属儿童医院放射科,重庆400014

出　　处：《暨南大学学报（自然科学与医学版）》2015年第2期178-181,共4页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：重庆市自然科学基金项目(2010BB5379)

摘　　要：目的:分析儿童麻疹肺炎的胸部影像学表现特点,提高对该病的影像学诊断能力及其远期并发症如闭塞性细支气管炎(BO)的早期识别能力.方法:91例患者均行胸部CT扫描,总结其CT及高分辨率CT(HRCT)资料,分析该病的影像学特点.结果:胸部CT表现:肺间质损害91例;片絮影57例,其中受累肺叶数≥3者32例;肺实变34例,累及肺叶数≥3者18例;磨玻璃影54例,胸膜增厚24例;纵隔气肿5例,气胸2例.63例患者存在小气道病变,其中,细支气管壁增厚52例,马赛克灌注征26例,小叶中心结节影22例,树芽征9例.17例重症麻疹肺炎患者在随访过程中,5例患者胸部HRCT一直显示有小气道病变.结论:儿童麻疹肺炎以肺间质损害合并双肺多灶性斑片影为主要改变,常常伴有磨玻璃影、胸膜病变;合并小气道病变常见,如出现小气道改变,尤其是重症患者,应进行临床及胸部HRCT随访除外闭塞性细支气管炎.Aim：To observe the chest CT features of measles pneumonia in children in order to en-heance the diagnostic ability and have an early indentification of the long-term complications,such as bronchiolitis obliterans （BO）,so as to improve the prognosis.Methods：The data of CT and HRCT in 91 children with MP were analyzed.Results：All the cases have interstitial lung changes,flocculent shadow was observed in 57 cases,which with 3 or more lobes invoved in 32 cases.Consolidation was ob-served in 34 cases,which with 3 or more lobes invoved in 18 cases.Ground-glass shadow was observed in 54 cases,pleural thickening in 24 cases,pneumothorax in 2cases and mediastinal emphysema in 5 cases. Small airway changes was observed：Bronchial wall thickening was observed in 54 cases,mosaic perfu-sion in 26 cases,centrilobular nodules in 22 cases,tree -in-bud in 9 cases.5 cases in 17 severe measles pneumonia cases showed small airway changes all the time.Conclusion：The main appearance of with measles pneumonitis in children are interstitial lung changes and multiple lesions patchy shadows, ground-glass shadow,pleural changes and small airway disease is common.If there are small airway chan-ges,expecially severe cases,bronchiolitis obliterans shall be identificated as early as possible.

关 键 词：麻疹肺炎 小气道疾病 闭塞性细支气管炎 计算机体层成像 

分 类 号：R511.1[医药卫生—内科学]