婴幼儿新型冠状病毒肺炎临床影像学分析  

Clinical and imaging analysis of COVID-19 in infants

作　　者：王芳[1] 张增俊[2] 邵剑波[1] 彭雪华 程春红[3] WANG Fang;ZHANG Zengjun;SHAO Jianbo;PENG Xuehual;CHENG Chunhong(Medical Imaging Center,Wuhan Children's Hospital,Wuhan Maternal and Child Healthcare Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China;Department of Radiology,Xi'an Children's Hospital,Xi'an 710003,China;Department of Radiology,Wuhan No.6 Hospital,Wuhan 430015,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)医学影像中心,湖北武汉430016 [2]西安市儿童医院放射科,陕西西安710003 [3]武汉市第六医院放射科,湖北武汉430015

出　　处：《实用放射学杂志》2021年第3期454-458,共5页Journal of Practical Radiology

基　　金：武汉市卫生计生科研基金面上重点项目(WX17B10)。

摘　　要：目的探讨婴幼儿新型冠状病毒肺炎(COVID-19)临床影像学表现。方法回顾性分析56例确诊为COVID-19婴幼儿胸部高分辨率CT(HRCT)影像学表现及临床治疗转归。HRCT影像特征包括病灶分布、位置、形态、密度及有无累及纵隔淋巴结和胸膜腔改变等。结果轻型4例,普通型50例,危重型2例;52例治疗好转出院(92.9%),合并支原体感染7例、其他病毒感染6例,继发心肌受损17例。其中普通型双肺累及多见(40%),单侧受累右肺多于左肺(38%:22%);多叶多部位较单叶多部位受累多见(40%:16%),同时受累多见(60%);累及肺段次之(18%)、整个肺叶受累少见(4%)。病灶呈磨玻璃影(26%)、实变影(40%)及混合性密度影(34%),未见纵隔淋巴结肿大及胸腔积液。危重型均累及多个肺段及肺叶,并可见胸腔积液。结论婴幼儿COVID-19普通型为主,危重症少,易发生混合性感染及继发心肌损害。胸部HRCT病变检出率高,影像学改变较成人轻。Objective To analyze of clinical and imaging findings of COVID-19 in infants.Methods High resolution CT(HRCT)images and clinical outcomes of 56 infants with COVID-19 admitted were analyzed retrospectively.The HRCT characteristics including the lesion distrbution,location,pattern,density,the abnormalities of the mediastinal lymph nodes and the pleural cavity were analyzed.Results Among the COVID-19 infants,there were 4 cases in the mild type,50 cases in the common type,and 2 cases in the severe type.The 52 infants(92.9%)were discharged after treatment,while the 7 infants were complicated with mycoplasma infection,the 6 infants were complicated with other viruses,and the 17 infants were affected by secondary myocardial injury.The bilateral lung involvement was more commonly in the common type(40%),the unilateral right lung involvement was higher than the left lung involvement(38%vs 22%).Multi-lobular and multi-part distribution was more common than single-lobular and multi-part distribution(40%vs 16%).It was more common to be affected at the same time(60%),the pulmonary segment to be affected was the second(18%),and the entire lobe involvement was rarely(4%).The lesions showed as ground glass opacity(26%),consolidation(40%)and mixed density(34%).There were no mediastinal lymph node enlargement and pleural effusion.Multiple segments and lobes were involved,and pleural effusion was found in all of the severe type infants.Conclusion For COVID-19 infants,the common type is the main type,while the severe type is rare.It is easy to complicate mixed infection and secondary myocardial damage.The detection rate of chest HRCT is high,and the image changes were lighter than those in adults.

关 键 词：新型冠状病毒肺炎 婴幼儿 计算机体层成像 

分 类 号：R563.1[医药卫生—呼吸系统] R814.42[医药卫生—内科学]