新生儿先天性肺气道畸形的影像学表现  

Radiologic features of congenital pulmonary airway malformation in neonates

作　　者：张大伟[1] 姚亮凤 邓庆健 姜帅 廖卫彬 崔运能[1] ZHANG Dawei;YAO Liangfeng;DENG Qingjian;JIANG Shuai;LIAO Weibin;CUI Yunneng(Department of Radiology,Foshan Maternity and Children*s Healthcare Hospital,Foshan 52800Q,China)

机构地区：[1]佛山市妇幼保健院放射科,广东佛山528000

出　　处：《实用放射学杂志》2020年第2期273-276,280,共5页Journal of Practical Radiology

基　　金：佛山市医学影像工程技术研究中心项目(FSOAAGKJ819G4901G0049).

摘　　要：目的探讨新生儿先天性肺气道畸形(CPAM)的影像学表现.方法回顾性分析经手术病理证实的17例新生儿CPAM患者临床及影像学资料.由2名放射科医师根据病灶的CT特征进行Stocker分型,在X线、CT、MR图像上分析CPAM病灶位置、形态、密度、信号等影像学改变,同时描述其并发症.结果17例患者,单发病灶15例,多发病灶2例,共19例病灶,其中1型4例,2型8例,3型7例.CPAM病灶在X线片上多表现为均匀或不均匀片状阴影,4例CPAM病灶在X线片上未见显示;CT可显示CPAM蜂窝状含气囊肿及软组织肿块特征,且可区分CPAM与肺炎病灶.17例患者中,合并新生儿肺炎12例,纵隔移位4例,肺隔离症1例,动脉导管未闭2例,肺大泡1例,气管性支气管1例.结论新生儿CPAM患者多合并肺炎,CT检查可有效剔除新生儿肺炎病灶影响,清晰显示病灶影像学特征及其并发症.Objective To explore the radiologic features of congenital pulmonary airway malformation(CPAM)in neonates.Methods The clinical and imaging data of 17 cases with neonatal CPAM confirmed by operation and pathology were analyzed retrospectively.Two radiologists categorized the lesions based on the Stocker’s classifications according to the CT features and analyzed the locations,morphology,density,signal intensity of the CPAM lesions on plain X-ray,CT and MR images.Additionally,the complications of CPAM were depicted too.Results Among the 17 patients,single lesions were showed in 15 patients and multiple lesions were showed in 2 patients,which resulted to 19 lesions totally.There were 4 lesions of type 1,8 lesions of type 2 and 7 lesions of type 3.On X-ray,the lesions commonly manifested as homogeneous or inhomogeneous patchy opacities,4 lesions were overlooked.CT could well demonstrate the characteristic features of CPAM as honeycomb like gas-filled cysts or soft tissue masses,and differentiate the CPAM from pneumonia lesions.Among the 17 patients,there were 12 cases complicated with pneumonia,1 case complicated with pulmonary sequestration,4 cases complicated with mediastinum shifting,2 cases complicated with ductus arteriosus,1 case complicated with lung bullae and 1 case complicated with tracheal bronchus.Conclusion Patients of neonatal CPAM complicated with pneumonia frcqucntly.CT can eliminate disturbance by pneumonia and clearly reveal the imaging characteristics of CPAM,as well as the complications.

关 键 词：新生儿 先天性肺气道畸形 计算机体层成像 磁共振成像 

分 类 号：R562.1[医药卫生—呼吸系统] R563[医药卫生—内科学]