儿童抗中性粒细胞胞浆抗体相关性血管炎的胸部CT表现  

Chest CT findings of antineutrophil cytoplasmic antibody associated vasculitis in children

作　　者：梁琼鹤[1] 杨明[1] 管红梅[1] LIANG Qionghe;YANG Ming;GUAN Hongmei(Department of Radiology,the Affiliated Children's Hospital of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院放射科,江苏南京210008

出　　处：《实用放射学杂志》2022年第4期634-638,共5页Journal of Practical Radiology

基　　金：南京医科大学科技发展基金一般项目(NMUB2018110).

摘　　要：目的探讨儿童抗中性粒细胞胞浆抗体相关性血管炎(AAV)的胸部CT表现.方法回顾性分析8例AAV患儿的临床及影像学资料,对其进行分类总结.结果8例患儿临床表现多样,涉及多个系统.8例患儿中显微镜下多血管炎(MPA)7例,肉芽肿性多血管炎(GPA)1例.MPA胸部CT主要表现为肺泡出血,伴肺间质、肺实质改变,胸膜增厚及胸腔积液;肺泡出血表现为两肺弥漫性絮状磨玻璃样密度影,肺间质改变主要表现为小叶间隔增厚.GPA表现为两肺弥漫性分布多发小结节,结节周边可见“晕征”,部分结节内空洞形成.结论儿童AAV的胸部CT表现具有一定的特征性.MPA以弥漫性肺泡出血表现为主,伴轻微的肺间质样改变;GPA主要表现为两肺弥漫性结节,伴有“晕征”及空洞.经早期、积极治疗后,肺部病灶可完全消失.Objective To investigate the chest CT findings of antineutrophil cytoplasmic antibody associated vasculitis(AAV)in children.Methods The clinical and imaging data of 8 children with AAV were analyzed retrospectively.Results The 8 cases had diverse clinical manifestations related to multiple systems.Seven cases were microscopic polyangiitis(MPA)and other one was granulomatosis with polyangiitis(GPA).Chest CT features of MPA included alveolar hemorrhage accompanied with pulmonary interstitial and parenchymal changes,pleural thickening and pleural effusion.Alveolar hemorrhage manifested as diffuse ground glass opacity on both lungs,and pulmonary interstitial changes mainly manifested as interlobular septum thickening.GPA showed diffuse and multiple small nodules distributed on two lungs with “halo sign”and cavity sometimes.Conclusion The chest CT findings of AAV in children has some special characteristics,including MPA with diffuse alveolar hemorrhage and slight pulmonary interstitial changes and GPA with diffuse pulmonary nodules with “halo sign”and cavity.After early and active treatment,lung lesions can completely disappear.

关 键 词：抗中性粒细胞胞浆抗体相关性血管炎 显微镜下多血管炎 肉芽肿性多血管炎 计算机体层成像 

分 类 号：R543[医药卫生—心血管疾病] R814.42[医药卫生—内科学]