小儿肺炎支原体肺炎MSCT影像学表现及对合并SP的鉴别诊断价值探讨  

Imaging Manifestations of MSCT of Mycoplasmal Pneumonia in Children and the Diagnosis Value for Mycoplasmal Pneumonia Combined with SP

作　　者：肖波涛[1] 高斌 邹晓倩 曹建华[1] 许锐 XIAO Bo-tao;GAO Bin;ZOU Xiao-qian(Department of Radiology,Huanggang Maternal and Child Health Hospital,Huanggang 438000,Hubei Province,China)

机构地区：[1]黄冈市妇幼保健院放射科,湖北黄冈438000 [2]武汉市江夏区第一人民医院放射科,武汉江夏430200 [3]黄冈市妇幼保健院门诊,湖北黄冈438000

出　　处：《中国CT和MRI杂志》2020年第10期37-39,43,共4页Chinese Journal of CT and MRI

基　　金：武汉市卫计委临床医学科研项目(编号:WX13B37)。

摘　　要：目的旨在探讨小儿肺炎支原体肺炎(MP)多层螺旋CT(MSCT)影像学表现及对合并链球菌属感染肺炎(SP)的鉴别诊断价值。方法将2014年1月至2017年12月于我院就诊治疗的82例MP患儿和38例合并SP的MP患儿作为研究对象,所有患儿均行MSCT检查,收集所有患儿临床及相关影像学资料,总结不同患儿在MSCT中的影像学表现及征象差异。结果MP患儿在MSCT检查中,支气管壁增厚、磨玻璃影、网状影和支气管血管束增厚表现率均显著高于MP+SP患儿(P<0.05),但两者在MSCT检查中支气管充气相和肺气肿表现率比较无明显差异(P>0.05);MP+SP患儿胸腔积液发生率显著高于MP患儿,且胸腔厚度、淋巴结最大直径均显著大于MP患儿(P<0.05);MP和MR+SP在MSCT检查中均可表现为支气管充气相、支气管壁增厚、磨玻璃影、网状影和支气管血管束增厚,但MP患儿表现更为明显,且胸腔积液较为少见,而MP+SP患儿胸腔积液量明显增多。两组患儿MSCT检查中均可在气管前腔静脉后发现肿大淋巴结影,但MP+SP患儿淋巴结最大横直径明显大于MP患儿,且MP患儿MSCT检查中可明显表现有呈扇形分布的薄片影,且以典型的自内向外呈现,而在MP+SP中主要表现为无规律分布的肺叶内实变影。结论在MP基础上出现明显淋巴结肿大,大量胸腔积液以及大片肺内实变影时可考虑为合并SP,而MSCT具有较高的图像分辨率,可清晰地显示出肺部组织结构,并对其进行多方位以及多角度的显示,更有利于MP和MP+SP的鉴别诊断。Objective To investigate the imaging manifestations of multi-slice spiral CT(MSCT)of Mycoplasmal pneumonia(MP)in children and the diagnosis value for Mycoplasmal pneumonia combined with Streptococcal pneumonia(SP).Methods 82 children with MP and 38 children with MP and SP were enrolled treated in our hospital from January 2014 to December 2017.All patients underwent MSCT examination,and all clinical and related imaging data were collected to summarize the imaging manifestations and signs of different children in MSCT.Results The occurrence rate of thickening of the bronchial wall,ground-glass opacity,reticular shadow and thickening of the bronchovascular bundle in MSCT examination of children with MP was significantly higher than that in MSCT examination of children with MP+SP(P<0.05).However,there was no significant difference in the occurrence rate of aerated bronchus sign emphysema between the two groups(P>0.05).The incidence rate of pleural effusion in children with MP+SP was significantly higher than that in children with MP,and the thickness of thoracic cavity and the maximum diameter of lymph node were significantly larger than those in children with MP(P<0.05).MP and MR+SP can show thickening of the bronchial wall,ground-glass opacity,reticular shadow and thickening of the bronchovascular bundle in MSCT examination,but the performance of MP children is more obvious,and pleural effusion is more rare,and the amount of pleural effusion in children with MP+SP increased significantly.In two groups,MSCT can detect enlarged lymph nodes in the anterior tracheal vein,but the maximum diameter of lymph node in children with MP+SP was significantly larger than that in children with MP.Moreover,in the MSCT examination of children with MP,there was a fan-shaped distribution of thin film,which was typically presented from inside to outside,In children with MP+SP,the main manifestations were irregularly distributed consolidation shadows in lung lobe.Conclusion When the children with MP show obviously swollen lymph node,a

关 键 词：肺炎支原体肺炎 多层螺旋CT 链球菌属感染肺炎 影像学特征 鉴别诊断 

分 类 号：R375.2[医药卫生—病原生物学]