小儿先天性肺气道畸形Ⅲ型CT特征分析  

CT Manifestation Analysis of Congenital Pulmonary Airway Malformation TypeⅢof the Lung in Children

作　　者：徐守军[1] 干芸根[1] 杨春兰[2] 曹娟[3] 刘龙平 罗娜[1] XU Shou-jun;GAN Yun-gen;YANG Chun-lan;CAO-juan;LIU Long-ping;LUO-Na(Department of Radiology,Shenzhen Children's Hospital,Shenzhen 518026,Guangdong Province,China;Department of Hematology and Oncology,Shenzhen Children's Hospital,Shenzhen 518026,Guangdong Province,China;Department of Pathology,Shenzhen Children’s Hospital,Shenzhen 518026,Guangdong Province,China)

机构地区：[1]深圳市儿童医院放射科,广东深圳518026 [2]深圳市儿童医院血液肿瘤科,广东深圳518026 [3]深圳市儿童医院病理科,广东深圳518026

出　　处：《中国CT和MRI杂志》2022年第12期63-65,共3页Chinese Journal of CT and MRI

基　　金：深圳市医疗卫生三名工程项目资助(SZSM202011005)。

摘　　要：目的探讨小儿先天性肺气道畸形(CPAM)Ⅲ型的CT特征,以提高对该病的影像学认识。方法回顾性分析2015年11月至2021年8月9例经手术、病理证实CPAMⅢ型(9个病灶)患儿的病例资料。术前均行CT平扫及增强扫描。结果9例9个病灶均位于一侧肺组织下叶,其中左肺下叶7例,右肺下叶2例。其中单纯CPAM 2例,CT表现为张力较低,肺纹理稀疏高透过区,与正常肺组织界限不清;其中1例病变区见少许斑片状高密度影及多个薄壁小囊,囊间见分隔。增强后无强化。合并先天性支气管闭锁(bronchial atresia,BA)1例,CT表现为高透过区内右肺下叶后基底段支气管远端未显示,增强后见条形未强化粘液栓影,周围有肺动脉分支血管伴行。合并先天性肺隔离症(BPS)6例,其中1例CT仅见大片肺纹理稀疏高透过区;2例呈不规则软组织块影,边缘少许肺组织透过度增高;其余3例表现为高透过度区内见实变影。增强后见腹主动脉供血5例,胸主动脉供血1例。结论CT为发现和诊断CPAMⅢ型的主要依据,具有特征性,熟悉其CT特征有助于提高对该病的诊断。Objective To investigate the CT features of children with congenital pulmonary airway malformation(CPAM)typeⅢ,in order to improve the knowledge of imaging findings of the disease.Methods We conducted a retrospective analysis the case data of the 9 children with CPAMⅢ(9 lesions)confirmed by surgery and pathology in our hospital from November 2015 to August 2021.All 9 cases were examined with plain and enhanced CT scans preoperative.Results All 9 cases(9 lesions)were located in the lower lobe of one side of the lung tissue,including 7 left lung and 2 right.Among them,2 cases of Simplex CPAMⅢshowed low tension,sparse lung markings and high density area on unenhanced CT,and the boundary with normal lung tissue was unclear;1 case showed a few patchy high-density shadows and multiple thin-walled small cysts,and separation between capsules,in the lesion area.No enhancement on enhanced CT.One case with congenital bronchial atresia(BA),CT showed that the distal end of the bronchus in the posterior basal segment of the right lower lobe was not shown in the high-permeability area,and a strip of unenhanced mucus emboli was seen after enhancement,surrounded by pulmonary artery branches Accompanying blood vessels.Congenital pulmonary sequestration(BPS)was found in 6 cases,among them,1 case showed only a large area of sparse lung markings and high permeability on CT;2 cases showed irregular soft tissue block shadow with a little increased permeability of lung tissue at the edge;the remaining 3 cases manifested as solid shadows in the high transmittance area.After enhancement,abdominal aortic blood supply was seen in 5 cases and thoracic aortic blood supply in 1 case.Conclusions CT examination is the main basis for discovery and diagnosis of CPAMⅢ.The CT manifestations of CPAMⅢare featured,Being familiar with these characteristics is helpful for its diagnosis.

关 键 词：肺气道畸形 先天性 体层摄影术 X线计算机 儿童 

分 类 号：R322.35[医药卫生—人体解剖和组织胚胎学]