儿童肺炎支原体肺炎合并肺栓塞的临床和影像学表现  

Clinical and imaging manifestations of mycoplasma pneumoniae pneumonia combined with pulmonary embolism in children

作　　者：杨利新[1] 王蓓[1] 徐保平[2] 唐晓璐[1] 孙记航[1] 彭芸[1] YANG Lixin;WANG Bei;XU Baoping;TANG Xiaolu;SUN Jihang;PENG Yun(Imaging Center,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China;Department of Respiratoryt,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China)

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呼吸科,北京100045

出　　处：《实用放射学杂志》2020年第5期784-787,共4页Journal of Practical Radiology

基　　金：北京高精尖创新中心项目(BHME-201908);北京市医院管理中心儿科学科协同发展中心专项经费资助项目(XTCX201814,XTZD20180104).

摘　　要：目的探讨儿童肺炎支原体肺炎(MPP)合并肺栓塞(PE)的临床和影像学表现.方法回顾性分析12例MPP合并PE患儿的临床特点、影像学表现及相关实验室检查结果,所有患儿均经CT肺血管造影(CTPA)确诊PE.结果12例患儿均以呼吸道症状就诊,D-二聚体水平均升高,8例(66.7%)患儿有突发胸痛、气促等症状.所有患儿均可见累及1个肺叶或肺段的大片实变,其中10例(83.3%)患儿血栓位于实变区肺动脉内,2例(16.7%)患儿血栓位于肺实变外,且均为多发血栓.此外,血栓位于亚段肺动脉及以远分支的患儿8例(66.7%),肺段动脉患儿3例(25%),肺叶动脉患儿1例(8.3%).结论MPP患儿伴有D-二聚体升高并症状突然加重时,要考虑PE的可能.CTPA是诊断PE的重要方法,MPP合并的PE多表现为肺实变内的多发小血栓.Objective To investigate the clinical and imaging manifestations of mycoplasma pneumoniae pneumonia(MPP)combined with pulmonary embolism(PE)in children.Methods The clinical features,imaging findings and related laboratory results of 12 children with MPP complicated by PE were analyzed retrospectively.All children were diagnosed with PE by computed tomography pulmonary angiography(CTPA).Results All of the 12 cases were adnmitted with respirtory symptoms,and D dimer levels were increased obriously.8 cases(66.7%)had sudden chest pain,breath shortness and other symptoms.Large areas of consolidation involving one pulmonary lobe or segment were found in all children.Thrombi of 10 cases(83.3%)were found in pulmonary arteries of the consolidation area,and thrombi of 2 cases(16.7%)were found outside the consolidation.All of them had multiple thrombi In addition,thrombi were located in subsegmental pulmonary arteries and distal branches in 8 cases(66.7%),the segmental pulmonary arteries in 3 cases(25%)and lobar pulmonary artery only in 1 case(8.3%).Condusion PE should be considered in children with MPP when D dimer level is increased obviously and symptoms get worse suddenly.CTPA is an important method to confirm PE,and MPP combined with PE is mostly manifested as muliple small thrombi in pulmonary arteries of pulmonary consolidation.

关 键 词：肺炎支原体肺炎 肺栓塞 计算机体层成像 

分 类 号：R563[医药卫生—呼吸系统] R563.5[医药卫生—内科学]