儿童腺病毒肺炎胸部CT表现与临床特点分析  

CT Findings and Clinical Features of Adenovirus Pneumonia in Children

作　　者：贾春阳 时胜利 JIA Chunyang;SHI Shengli(Department of Radiology,Children’s Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan Province 450000,P.R.China)

机构地区：[1]郑州大学附属儿童医院放射科,450000

出　　处：《临床放射学杂志》2023年第3期472-476,共5页Journal of Clinical Radiology

摘　　要：目的探讨儿童腺病毒(ADV)肺炎临床与胸部CT表现及部分患儿治疗后的动态变化特点。方法总结38例确诊ADV肺炎的住院患儿,回顾住院时各类临床特点与肺部的影像表现,按照重症肺炎(7例,18.4%)与轻症肺炎(31例,81.6%)两组区分,并对二者之间的临床特点与影像表现进行统计学分析。结果咳嗽与发热为ADV肺炎最多见临床表现,患儿合并既往有先天性心脏病史或同时混合其他病原学感染则更容易发展为重症肺炎(P<0.05)。影像特点:(1)ADV肺炎在CT上表现方式具有多样性特点。(2)重症肺炎在CT各类异常表现程度(双肺受累、病变范围、小叶间隔增厚、肺部磨玻璃样改变以及胸膜增厚、胸腔积液)等较轻症肺炎更加显著(P<0.05)。(3)炎性病灶分布形态多以自单侧肺门延伸至一侧肺叶(段)中外带,病灶前(后)缘止步于叶间胸膜处,并以宽基底与胸膜接壤形式最为多见(73.7%,28/38)。(4)部分患儿2次CT动态观察提示无论按照炎症严重程度区分或按照是否合并混合感染区分,治疗后原病灶基本趋于正常。结论尽管儿童ADV肺炎临床表现与实验室检查没有一定特异性,但是在影像上炎性病灶分布特点具有一定特征性。较轻症肺炎而言,重症肺炎在CT各类表现程度更显著,但无论轻症或重症ADV肺炎,患儿最终胸部CT均较少有残留病灶。纵观ADV肺炎动态变化过程,与临床动态变化基本趋于一致。Objective To investigate the clinical features and chest CT findings of adenovirus(ADV)pneumonia in children and the dynamic changes of some children after treatment.Methods A total of 38 inpatients diagnosed with ADV pneumonia were summarized,The clinical features and the CT imaging findings of the lungs at admission were reviewed,DO some statistical analysis with two groups according to severe pneumonia(7 cases,18.4%)and mild pneumonia(31 cases,81.6%)were classified.Results ADV pneumonia with cough and fever were the most common clinical cases.Children with congenital heart disease or mixed with other etiological infections were more likely to develop severe pneumonia(P<0.05).The main changes on CT scans are:(1)ADV pneumonia has diverse features on CT.(2)Severe pneumonia was more significant(bilateral lung involvement,lesion extent,interlobular septal thickening,pulmonary ground-glass changes,and pleural thickening)in Milder pneumonia,such as various abnormal manifestations on CT(P<0.05).(3)The distribution of inflammatory lesions in this group mostly extended from unilateral hilum to the middle and outer bands of one lobe(segment)and stopped at the anterior(posterior)edge of the lesion.It is the most common in the interlobar pleura,with a wide base bordering the pleura(73.7%,28/38).(4)Dynamic observation of children with continuous CT scans suggests that no matter whether it is differentiated by the severity of inflammation or it is combined with mixed infection,the chest CT tends to be normal.Conclusion Although the clinical manifestations and laboratory tests of ADV pneumonia in children are not specific,the distribution of inflammatory lesions on imaging has certain characteristics.Compared with mild pneumonia,severe pneumonia is more obvious in various CT manifestations,but no matter the mild or severe ADV pneumonia,children both have fewer residual lesions in the final chest CT scans.Throughout the dynamic change process of ADV pneumonia,it is the same as the clinical dynamic change and tends to be consis

关 键 词：儿童 腺病毒 支原体肺炎 体层摄影术 X线计算机 

分 类 号：R725.6[医药卫生—儿科] R816.92[医药卫生—临床医学]