通气控制高分辨率CT诊断毛细支气管炎小气道病变的价值  

Value of ventilation control high-resolution CT in the diagnosis of small airway lesions in bronchiolitis

作　　者：袁伟华 胡栋梁 易阳[1] YUAN Weihua;HU Dongliang;YI Yang(Department of Imaging,Changzhou Children’s Hospital Affiliated to Nantong University,Changzhou,Jiangsu Province 213003,China;Department of Imaging,Children’s Hospital Affiliated to Soochow University,Suzhou,Jiangsu Province 215000,China)

机构地区：[1]南通大学附属常州儿童医院影像科,江苏常州213003 [2]苏州大学附属儿童医院影像科,江苏苏州215000

出　　处：《实用放射学杂志》2023年第11期1843-1846,共4页Journal of Practical Radiology

摘　　要：目的探讨通气控制高分辨率CT在婴幼儿毛细支气管炎小气道病变中的诊断价值。方法选取79例拟诊断为毛细支气管炎小气道病变患儿,均行通气控制高分辨率CT呼气、吸气相扫描及肺功能诊断,将肺段内出现“马赛克灌注征”记为异常。记录通气控制高分辨率CT及肺功能检测结果,分析2种诊断方法的一致性。结果79例患儿动脉弓上缘、隆嵴水平、左肺门下缘、膈上2 cm处共出现“马赛克灌注征”肺段703个、支气管壁增厚237支、支气管扩张888支;78例(98.73%)出现“马赛克灌注征”,48例(60.76%)出现支气管壁增厚、51例(64.56%)出现支气管扩张。79例患儿中,呼吸频率(RR)为(31.25±5.01)次/min,潮气量(TV)为(7.98±1.13)mL、达峰时间比(TPTEF/TE)为(15.94±2.92)%,达峰容积比(VPTEF/VE)为(20.36±3.59)%,功能残气量(FRC)为(360.87±41.07)mL。通气控制高分辨率CT与肺功能诊断的一致性Kappa值为0.761,通气控制高分辨率CT与肺功能诊断的符合率分别为96.15%。结论通气控制高分辨率CT与肺功能诊断婴幼儿毛细支气管炎小气道病变具有较高一致性,肺功能诊断可辅助通气控制高分辨率CT区分肺通气及血灌注损伤情况。Objective To explore the value of high-resolution CT of ventilation control in the diagnosis of bronchiolitis with small airway lesions in infants and young children.Methods A total of 79 children with bronchiolitis and small airway lesions were selected.All children were diagnosed by ventilation control high-resolution CT and lung-function testing.The appearance of“mosaic perfusion sign”in the lung segments were recorded as abnormal.The diagnosis results of ventilation control high-resolution CT and lung-function testing were recorded.The consistency of the two diagnostic methods was analyzed.Results There were 703“mosaic perfusion sign”lung segments,237 bronchial wall thickening,and 888 bronchiectasis at the upper edge of the arterial arch,carina level,lower edge of left pulmonary hilum,2 cm above diaphragm in 79 children.“Mosaic perfusion sign”was found in 78 cases(98.73%),bronchial wall thickening in 48 cases(60.76%),and bronchiectasis in 51 cases(64.56%).Respiratory rate(RR)was(31.25±5.01)breaths/min,tidal volume(TV)was(7.98±1.13)mL,TPTEF/TE was(15.94±2.92)%,VPTEF/VE was(20.36±3.59)%,and functional residual capacity(FRC)was(360.87±41.07)mL among 79 children.The consistency Kappa value of ventilation control high-resolution CT and lung-function testing was 0.761,and the coincidence rate of ventilation control high-resolution CT and lungfunction testing was 96.15%.Conclusion Ventilation control high-resolution CT and pulmonary-function testing are highly consistent in the diagnosis of bronchiolitis with small airway lesions in infants and young children.Pulmonary-function testing can assist ventilation control high-resolution CT to distinguish pulmonary ventilation and blood perfusion injury.

关 键 词：婴幼儿 小气道病变 计算机体层成像 

分 类 号：R562.21[医药卫生—呼吸系统] R814.42[医药卫生—内科学]