儿童支原体肺炎CT影像学特点及与支气管镜检查对照分析  

CT imaging features as well as comparative analysis with bronchoscopy of mycoplasma pneumonia in children

作　　者：洪晓纯[1] 王忠[1] 邹姒妮[2] 郑晓林[3] HONG Xiaochun;WANG Zhong;ZOU Sini;ZHENG Xiaolin(Department of Radiology,Dongguan Maternal and Child Health Care Hospital,Dongguan,Guangdong Province 523000,China;Department of Pediatrics,Dongguan Maternal and Child Health Care Hospital,Dongguan,Guangdong Province 523000,China;Department of Radiology,the People's Hospital of Dong guan,Dong guan,Guangdong Province 523059,China)

机构地区：[1]东莞市妇幼保健院放射科,广东东莞523000 [2]东莞市妇幼保健院儿科,广东东莞523000 [3]东莞市人民医院放射科,广东东莞523059

出　　处：《实用放射学杂志》2021年第12期2047-2050,共4页Journal of Practical Radiology

摘　　要：目的探讨儿童支原体肺炎的CT影像学特点及与支气管镜检查结果的对照。方法回顾性分析75例儿童支原体肺炎患者,均经支气管镜检查,并以肺泡灌洗检查结果作为确诊金标准,确诊前均行多层螺旋CT检查,并将CT检查结果与支气管镜进行比较,分析CT诊断效果及影像学特点;绘制受试者工作特征(ROC)曲线,分析CT在儿童支原体肺炎患者中的诊断效能(敏感性、特异性)。结果病灶以双侧、多叶受累为主,CT检查儿童支原体肺炎具有典型的影像学特点,主要表现为支气管壁增厚(100.00%);其次为树雾征(86.67%)、树芽征(80.00%)、大片状实变(76%),病变部位其余CT表现有散在斑片状、斑点状渗出灶,小叶中心结节,磨玻璃样阴影,少部分出现肺间质改变、胸腔积液、肺气肿及淋巴结肿大;CT检查最终确诊71例,诊断符合率94.7%,支气管镜检查均有支气管内膜炎及支气管壁肿胀;ROC曲线结果表明,CT在儿童支原体肺炎患者中曲线下面积(AUC)为0.857,诊断灵敏度为0.885,特异度为0.793。结论CT用于儿童支原体肺炎中能获得与支气管镜检查结果较高的诊断符合率,能清晰显示肺内病变,可获得较高的诊断敏感性、特异性。Objective To explore the CT imaging features and the comparison with the results of bronchoscopy of mycoplasma pneumonia in children.Methods 75 cases of children with mycoplasma pneumonia were performed bronchoscopy,and the results were confirmed by the alveolar lavage examination.Multi-slice spiral CT examinations were performed before the diagnosis in 75 cases,and the CT examination results were compared with bronchoscopy of mycoplasma pneumonia.Then,the CT diagnosis value and imaging characteristics were analyzed;CT diagnostic efficacy(sensitivity,specificity)was analyzed by drawing receiver operating characteristic(ROC)curve.Results The lesions were mainly bilateral and multiple lobes involved.Mycoplasma pneumonia in children with CT examination had typical imaging features,mainly manifested as thickening of the bronchial wall(100.00%);Followed by tree fog sign(86.67%),tree-in-bud sign(80.00%),large patchy consolidation(76%),as well as the CT features of the scattered patchy,speckled shadows,nodules in the center of the leaflets,ground glass-like shadows,and minor manifestations with pulmonary interstitial changes,pleural effusion,emphysema,and lymphadenopathy;Finally 71 cases with mycoplasma pneumonia were diagnosed by CT examination,and the diagnostic coincidence rate was 94.7%.Bronchoscopy confirmed that the lung lesions had endobronchitis and bronchial wall swelling in all cases.The ROC curve results showed that CT had an area under the curve(AUC)of 0.857,a diagnostic sensitivity of 0.885 and a specificity of 0.793 in children with mycoplasma pneumonia.Conclusion CT used in children with mycoplasma pneumonia can obtain a high diagnosis coincidence rate compared with bronchoscopy results,clearly show lung lesions,obtain high diagnostic sensitivity and specificity.

关 键 词：儿童 支原体肺炎 计算机体层成像 支气管镜检查 

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