儿童肺炎支原体肺炎肺栓塞双能谱CT成像的研究  

A Study on Dual Energy Spectrum CT Imaging of Pulmonary Embolism Caused by Mycoplasma Pneumoniae Pneumonia in Children

作　　者：林晓杰 于茂敏 李堂 薛同庆 LIN Xiao-jie;YU Mao-min;LI Tang;XUE Tong-qing(Department of Pediatrics,Qingdao Eighth People's Hospital,Qingdao 266000,Shandong Province,China;Department of Pediatric Endocrinology and Genetic Metabolism,Qingdao Women and Children's Hospital,Qingdao 266000,Shandong Province,China;Department of Anesthesiology,Huai'an Hospital,Huai'an 223211,Jiangsu Province,China)

机构地区：[1]青岛市第八人民医院儿科,山东青岛266000 [2]青岛市妇女儿童医院儿科内分泌与遗传代谢科,山东青岛266000 [3]淮安市淮安医院麻醉科,江苏淮安223211

出　　处：《中国CT和MRI杂志》2025年第3期49-51,共3页Chinese Journal of CT and MRI

基　　金：江苏省卫生健康委科研项目(Z2021045)。

摘　　要：目的探讨双能谱CT在诊断儿童肺炎支原体肺炎(MPP)肺栓塞中的应用价值。方法对83例MPP合并高度怀疑肺栓塞(PE)的患儿行CT肺血管造影(CTPA)扫描,其中25例确诊为PE。评估图像质量和诊断置信度,对患儿治疗前后实变区、灌注缺损区及正常肺、灌注缺损区的碘浓度(IC)进行检测。结果检测儿童PE的最佳能量水平为55keV。缺损区IC值分别为0.69±0.28 mg/m L(外实变)和0.90±0.23 mg/mL(实变内),均显著低于正常肺的2.76±0.45 mg/mL和无实变的10.25±1.76 mg/mL(P<0.001)。闭塞血栓与非闭塞血栓有无血流灌注缺损率差异有统计学意义(P<0.001)。治疗后血流灌注缺损区的IC明显增加(P<0.001)。结论在双能谱CTPA中,55keV图像对儿童PE的检出效果最佳,而MD图像可定量显示PE的肺血流,有助于发现细小的血栓和量化栓塞度。Objective To explore the application value of dual energy spectrum CT in the diagnosis of pulmonary embolism caused by Mycoplasma pneumoniae pneumonia(MPP)in children.Methods CT pulmonary angiography(CTPA)was performed on 83 children with MPP and highly suspected pulmonary embolism(PE),of which 25 were diagnosed with PE.Evaluate image quality and diagnostic confidence,and detect iodine concentration(IC)in the consolidation area,perfusion defect area,normal lung,and perfusion defect area of the patient before and after treatment.Results The optimal energy level for detecting PE in children is 55keV.The IC values of the defect area were 0.69±0.28 mg/m L(external consolidation)and 0.90±0.23 mg/m L(internal consolidation),respectively,which were significantly lower than the normal lung's 2.76±0.45 mg/m L and non consolidation's 10.25±1.76 mg/m L(P<0.001).There was a statistically significant difference(P<0.001)in the incidence of blood flow perfusion defects between occlusive and non occlusive thrombosis.After treatment,the IC in the blood flow perfusion defect area significantly increased(P<0.001).Conclusion In dual spectrum CTPA,the 55 keV image has the best detection effect on pediatric PE,while the MD image can quantitatively display the pulmonary blood flow of PE,which helps to detect small thrombi and quantify the degree of embolism.

关 键 词：肺炎支原体肺炎 儿童肺炎 双能谱CT 肺栓塞 

分 类 号：R375.2[医药卫生—病原生物学]