儿童侵袭性肺部真菌感染高分辨率CT表现的差异性研究  

Differences of HRCT findings in children with invasive pulmonary fungal infections

作　　者：李宁[1] 赵鹏 柳澄[1] 闫欣[1] 周云娜[1] 毕万利[1] LI Ning;ZHAO Peng;lIU Cheng;YAN Xin;ZHOU Yunna;BI Wanli(Shandong Medical Imaging Research Institute,Ji'nan 250021,China;Department of Radiology,Shandong Provincial Hospital,Shandong First Medical University,Ji'nan 250021,China)

机构地区：[1]山东省医学影像学研究所,山东济南250021 [2]山东第一医科大学附属省立医院医学影像科,山东济南250021

出　　处：《实用放射学杂志》2020年第11期1821-1824,共4页Journal of Practical Radiology

摘　　要：目的探讨儿童侵袭性肺部真菌感染(IPFI)的特征性高分辨率CT(HRCT)表现及表现差异的影响因素.方法回顾性分析53例IPFI患儿的临床及影像资料,包括易感因素、免疫状态、肺部病灶类型、数目、分布规律及治疗后转归情况.组间差异性比较采用χ^2检验.结果(1)53例IPFI患儿中肺炎相关者占47.2%,血液病者占43.4%,后者中性粒细胞缺乏发生率为100%.(2)98.1%的IPFI CT表现为肺部多发病灶,2种及以上病变形态共存者占64.2%.以实变(52.8%)、结节(49.1%)最常见,其次为磨玻璃密度灶(20.8%)、空洞(17%)、树芽征(13.2%)、晕征(9.4%)及新月征(3.8%).非血液病患儿实变和磨玻璃密度灶的发生率(73.3%,33.3%)高于血液病患儿(26.1%,4.3%,P<0.05),而后者结节及晕征的发生率(73.9%,21.7%)高于前者(30%,0%,P<0.05).结论双肺多发实变、结节/肿块且多种形态并存是儿童IPFI的特征性CT表现.机体免疫状态及影像检查时间是HRCT表现差异的影响因素.Objective To investigate the high-resolution CT(HRCT)characteristics of invasive pulmonary fungal infections(IPFI)in children and the factors that influence the HRCT manifestations.Methods 53 children with IPFI were selected in this retrospective study,and their clinical and imaging data were analyzed including susceptible factors,immune status,and the types,number,distribution and outcome after treatment of the lung lesion.x^2 test was used to compare the differences between different groups.Results(1)Among the 53 children with IPFI,47.2%of the cases were pneumonia-related,and 43.4%of the cases had blood diseases with 100%of neutrophil deficiency rate.(2)Multiple lesions were found in 98.1%of IPFI,and 64.2%of them had two or more types of lesions.Consolidation(52.8%)and nodule(49.1%)were the most common features,followed by glass-ground density(20.8%),void(17%),tree bud sign(13.2%),halo sign(9.4%)and monthly sign(3.8%).The incidences of consolidation and ground-glass opacity in children with non-blood disease(73.3%and 33.3%)were higher than those with blood disease(26.1%and 4.3%,P<0.05),while the incidences of nodule and halo in the latter group(73.9%and 21.7%)were higher than those in the former group(30%and 0%,P<0.05).Conclusion Multiple consolidations and nodules/lumps coexist in the bilateral lung are the most common CT features for children with IPFI.Immune status and imaging examination time are two influence factors in cHfferent HRCT manifestations.

关 键 词：儿童 侵袭性肺部真菌感染 计算机体层成像 

分 类 号：R563[医药卫生—呼吸系统] R814.42[医药卫生—内科学]