肺部高频超声与CT扫描对儿童肺炎支原体肺炎的诊断效能对比研究

Comparison of diagnostic performance of high-frequency ultrasound and CT for mycoplasma pneumoniae pneumonia in children

目的对比分析肺部高频超声与CT扫描在儿童肺炎支原体肺炎(MPP)的诊断效能。方法选取2017年1月至2021年1月无锡市儿童医院收治的86例MPP患儿,均行肺部高频超声和CT扫描检查,分析患儿影像学表现与特点,比较高频超声与肺部CT对儿童MPP诊断效能。结果86例MPP患儿中76例(88.37%)肺部高频超声B线,61例(70.93%)胸膜线中断、变细或消失,41例肺(47.67%)实质或支气管征,19例(22.09%)A线可见蝙蝠征、水平伪影,9例(10.47%)肺滑动征不可见,6例(6.98%)白肺。86例MPP患儿CT扫描均可见肺部纹理异常,不同程度的弥散磨玻璃影或伴支气管网状影,部分患儿支气管束增厚并呈充气征,少数患儿表现胸腔积液。肺部超声诊断儿童MPP符合率为93.02%,误诊率为6.98%;肺部CT诊断儿童MPP符合率为100%,误诊率为0%,差异具有统计学意义(P<0.05)。以肺部CT为“金标准”,ROC曲线显示肺部高频超声诊断儿童MPP的曲线下面积(AUC)为0.865(95%CI:0.762~0.921),敏感度为88.36%,特异度为80.09%。结论与肺部CT扫描相比,肺部高频超声对儿童MPP具有较高的诊断符合率和一致性。肺部高频超声可作为儿童MPP辅助诊断手段之一,从而降低患儿射线暴露,具有较高临床价值。

ObjectiveTo compare the diagnostic performance of high-frequency ultrasound and CT in children with mycoplasma pneumoniae pneumonia(MPP).MethodsA total of 86 MPP children were admitted to Wuxi Children's Hospital from January 2017 to January 2021.High-frequency ultrasound and CT scanning of the lungs were performed to analyze the imaging manifestations and characteristics in children patients,and the diagnostic performance of high-frequency ultrasound and CT was compared.ResultsOf the 86 children with MPP,76(88.37%)had B-line of high-frequency ultrasound in the lung,61(70.93%)had interrupted,thinned,or disappearing pleural line,41(47.67%)had lung parenchyma or bronchial sign,19(22.09%)had bat sign and horizontal artifact on A-line,9(10.47%)had no visible lung glide sign,and 6(6.98%)had white lung.CT showed abnormal lung textures,varying degrees of diffuse ground-glass opacity with bronchial reticular opacity,thickening and inflation of bronchial bundles in some MPP children,and pleural effusion in a few MPP children.The accuracy rate and misdiagnosis rate of ultrasound diagnosis were 93.02%and 6.98%,respectively,and the corresponding rates of CT diagnosis were 100%and 0%,respectively;the difference between them was statistically significant(P<0.05).Using lung CT as the"gold standard",ROC curve analysis showed that the AUC of high-frequency ultrasound diagnosis in children with MPP was 0.865(95%CI:0.762~0.921),with a sensitivity of 88.36%and specificity of 80.09%.ConclusionHigh-frequency ultrasound has a high diagnostic accuracy for MPP in children,and it can be used as an auxiliary diagnostic tool for children MPP,so as to reduce the radiation exposure.