胸部X线片在小儿呼吸道合胞病毒肺炎诊断及鉴别诊断中的应用价值  

Chest radiographic features and differential diagnosis of respiratory syncytial virus in children

作　　者：谢囡霭 周洁[1] 向子云[1] Xie Nan'ai;Zhou Jie;Xiang Ziyun(Department of Radiology,Shenzhen Longgang People’s Hospital,Shenzhen 518172,China)

机构地区：[1]广东省深圳市龙岗区人民医院影像科,广东深圳518172

出　　处：《新发传染病电子杂志》2021年第3期230-233,共4页Electronic Journal of Emerging Infectious Diseases

摘　　要：目的探讨小儿呼吸道合胞病毒肺炎的胸部X线片特征,评价胸部X线片在呼吸道合胞病毒肺炎中的诊断及鉴别诊断价值。方法回顾性分析经鼻腔拭子核酸检测确诊为呼吸道合胞病毒肺炎感染患儿的临床及影像学资料,总结小儿呼吸道合胞病毒肺炎的影像学特征表现,与儿童常见病毒性肺炎进行鉴别。结果153例呼吸道合胞病毒肺炎确诊患儿的胸部X线片中,102例(66.7%)肺内病变表现为沿支气管血管束分布的多发斑片状密度增高影,主要累及肺野内中带(57例,37.2%),6例(3.9%)可见实变影,多分布于右上肺野及两下肺野;42例(27.5%)仅表现为支气管炎改变;所有患儿均无胸腔积液。结论虽然小儿呼吸道合胞病毒肺炎需经病原学确诊,但胸部X线片辐射剂量低、可操作性强,对肺内病变的检出、分布及严重程度的评估具有较高应用价值。Objective To investigate the chest X-ray features of children with respiratory syncytial virus pneumonia(RSV),and to evaluate the value of chest X-ray in the diagnosis and differential diagnosis of respiratory syncytial virus pneumonia.Methods To retrospectively analyze the clinical and imaging data of children with respiratory syncytial virus pneumonia diagnosed by nasal swab nucleic acid detection,summarize the characteristic manifestations of children with respiratory syncytial virus pneumonia on chest X-ray,and identify the common viral pneumonia related literature in children.Results In the chest X-ray of 153 children with respiratory syncytial virus pneumonia,102 cases(66.7%)showed multiple patchy hyperdense shadows distributed along the bronchovascular bundle,mainly involving the inner zone of bilateral lung fields(57 cases,37.2%),and 6 cases(3.9%)showed pulmonary consolidation,mostly distributed in the right upper lung field and bilateral lower lung fields;42 cases(27.5%)only showed bronchitis;No pleural effusion was found in all patients.Conclusion Although the diagnosis of respiratory syncytial virus pneumonia in children should be confirmed by etiology,the radiation dose of chest X-ray is low and easy to operate,which plays an irreplaceable role in the detection,distribution and severity evaluation of lung lesions.

关 键 词：呼吸道合胞病毒 病毒性肺炎 小儿肺炎 胸部X线片 影像诊断 

分 类 号：R725.6[医药卫生—儿科]