60例成人支原体肺炎的临床及CT影像特征  

Clinical and CT features of 60 cases of adult mycoplasma pneumonia

作　　者：蔡沁馨 李红林 王笑转 李婷 周全 CAI Qinxin;LI Honglin;WANG Xiaozhuan;LI Ting;ZHOU Quan(Department of Radiology, the Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China;Department of Respiratory Medicine, the Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China)

机构地区：[1]南方医科大学第三附属医院医学影像科,广东广州510630 [2]南方医科大学第三附属医院呼吸内科,广东广州510630

出　　处：《暨南大学学报（自然科学与医学版）》2020年第4期330-335,共6页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：国家自然科学基金重点项目(81630046)。

摘　　要：目的:分析成人支原体肺炎的临床特征及CT表现,旨在提高对该病的认识及与其他肺炎的鉴别.方法:回顾性总结支原体核酸检测阳性的60名成人支原体肺炎患者的临床及影像学资料,探讨其临床及影像学特点.结果:全组年龄处于18~35岁占75%,表现为高热占55%.实验室检查:83%白细胞计数(WBC)正常,60%中性粒细胞百分比升高,98%C反应蛋白(CRP)增高.CT影像表现:病变累及单个肺叶占73%,累及右肺下叶占47%;小叶中心分布占90%;呈团片状占62%,呈磨玻璃影占80%,肺实变占38%;病灶边缘欠清占68%,75%见树芽征,85%支气管壁增厚,38%见支气管气象;2%见胸腔积液,未见合并空洞.结论:成人支原体肺炎大多数见于青年人,临床表现以高热常见;常见中性粒细胞百分比及CRP增高且不伴有WBC增高.CT以右肺下叶受累为主,常见小叶中心分布的团片状、边缘欠清的磨玻璃样影,伴或不伴肺实变,罕见胸腔积液及肺空洞,支气管壁增厚及树芽征多见,支气管气象相对少见;不同于常见细菌性肺炎的以实变为主并伴支气管气象;虽然与新型冠状病毒肺炎(COVID-19)同样多表现为磨玻璃密度影,但支原体肺炎以小叶中心分布为主,伴有支气管壁增厚及树芽征.Objective:To summarize the clinical features and CT observations of mycoplasma pneumoniae pneumonia(MPP)in adults aiming to improve the recognition of the disease and differentiate it from other pneumonia.Methods:Retrospectively summarized the clinical and imaging data of 60 patients with positive results of mycoplasma DNA test and analyzed their clinical as well as imaging characteristics.Results:Among the 60 cases,75%were aged 18~35 years and 55%were hyperpyrexia.Laboratory tests showed that among the participants,83%had normal white blood cell count(WBC),60%had increased neutrophils and 98%had increased c-reactive protein(CRP).CT findings showed that 73%of the lesions involved a single lobe,47%of the lesions involved the lower lobe of the right lung.Lobular central distribution accounted for 90%,62%presenting as mass-like shadow,80%presenting as ground glass opacity,38%presenting as consolidation.According to the observation,68%of lesions margin were unclear,75%showed tree bud sign,85%of bronchial wall thickening,38%showed bronchial meteorology,2%combined with pleural effusion,and no cavity was found.Conclusion:Adult mycoplasma pneumonia is most common in young people,and the clinical manifestations of hyperpyrexia is also frequently.The increasing of common neutrophils and CRP didn't affect WBC.CT results showed that the lesions were mainly involved in the lower lobe of the right lung,with mass-like shadow in the center of the lobules,less clear ground glass opacity at the edges,with or without lung consolidation,pleural effusion and pulmonary cavity are rarely seen,bronchial wall thickening and treebud signs are common,bronchial meteorology is relatively rare.Different from common bacterial pneumonia,consolidation is the main feature and accompanied by bronchometeorology.Although the ground glass opacity is same as that of Corona Virus Disease 2019(COVID-19),mycoplasma pneumonia is mainly distributed in the center of lobule,accompanied by thickening of bronchial wall and tree bud sign,which distinguished fro

关 键 词：肺炎 支原体 多层螺旋CT 临床特征 

分 类 号：R445.3[医药卫生—影像医学与核医学]