儿童特发性肺含铁血黄素沉着症的影像学分析:比较X线与CT的诊断价值

Idiopathic Pulmonary Hemosiderosis in Children:Comparison of Radiographic and CT Findings

目的:比较观察X线平片、常规CT和HRCT对儿童特发性肺含铁血黄素沉着症(IPH)胸内病变中的诊断价值。方法:对13例IPH患者进行胸部X线平片、常规CT和HRCT检查,将影像表现分类,并以HRCT为标准,评价X线平片和常规CT的诊断价值。结果:HRCT显示的肺内局限性病变包括均匀磨玻璃影(11例)、晕状影(7例)、结节影(6例)和不均匀磨玻璃影(1例);非局限性病变包括磨玻璃(3例)、细网状(7例)和细沙粒状改变(2例)。X线平片诊断上述病变征象的例数分别为7、0、2、0、1、3、0例。常规CT为10、6、4、0、3、3、0例。结论:X线和常规CT对显示IPH主要肺部改变各有优缺点,HRCT优于这2种方法。X线平片仍应作为IPH的主要影像检查手段,对于有不良预后因素或临床高度怀疑为继发性肺含铁血黄素沉着症的患者,可根据实际情况选择HRCT或常规CT。

Objective：To compare the role of radiography,conventional computed tomography （CCT） and high resolution CT （HRCT） in the detection of intrathoracic abnormalities in pediatric patients with idiopathic pulmonary hemosiderosis （IPH）. Methods： 13 patients with IPH underwent radiography,CCT and HRCT of the chest. Taking the manifestations of HRCT as the gold standard, the diagnositic value of radiography and CCT were evaluated. HRCT showed intra-pulpomary local lesions including homogeneous ground-glass opacities （GGO, n = 11 ）, halo-like opacity （ n = 7 ）, nodule （ n = 6 ） and heterogeneous GGO （n= 1 ）. For the disseminated intra-pulmonary lesions, there were GGO （n= 3）, fine recticular pattern （n= 7） and psammous pattern （n= 2）. Results： Correlated with the above-mentioned findings, radiography showed 7,0, 2,0 ; 1,3,0 features and CCT showed 10,6,4,0 ; 3,3,0 features respectively. Conclusion ： Radiography and CCT had their own individual advantages and disadvantages in showing IPH lesions. HRCT is superior to both of them in the detection of intrapulmonary abnormalities. Radiography is still warranted to be the major imaging examination for the patients with IPH, while for those patients with poor prognostic factors or clinically highly suspected as secondary pulmonary hemosiderosis,HRCT or CCT is recommended.