成人支原体肺炎的CT影像表现

CT features of mycoplasma pneumoniae pneumonia in adult patients

目的分析35例成人支原体肺炎患者的CT影像学特点,指导临床对支原体肺炎的初步诊断。方法对血清学证实的35例成人支原体肺炎患者的胸部CT进行回顾性分析,CT的分析由两位观察者分别独立进行。结果①35例患者中,男9例,占25.7%,女26例,占74.3%。女性发病率明显高于男性。(χ2=8.26;P<0.005)。②在25例病变分布于单侧肺内的患者,左侧19例,右侧6例,左侧发病明显多于右侧(χ2=6.76;P<0.01)。对35例患者各个叶段发病的统计显示,左下叶的发病例数明显多于其他叶段(χ2=15.709;P<0.01)。③CT影像上可见到磨玻璃密度阴影者占97.1%,其特点为由磨玻璃影逐渐过度到大片实变影,或在磨玻璃影像中,散在分布多发斑片状实变影,或上两种改变同时存在,或在磨玻璃影像中散在分布结节影,所占比例分别为71.4%、74.3%、48.6%和68.6%。胸腔积液者占40.0%,纵隔淋巴结增大者占28.6%。结论成人支原体肺炎女性发病率高于男性,左肺发病多于右肺,其胸部CT影像上的一些特点对支原体肺炎的诊断具有提示作用。

Objective To analyze the CT imaging characteristics of Mycoplasma pneumoniae pneumonia in 35 adult patients in order to guide the preliminary clinical diagnosis of Mycoplasma pneumoniae pneumonia. Methods The chest CT scans obtained from 35 adult patients with serologically proven Mycoplasma pneumoniae pneumonia were retrospectively reviewed. CT scans were analyzed independently by two observers. Results ①There were 9 cases （25. 7%） of male and 26 cases （74.3%） of female among the 35 patients and the morbidity rate of female was significantly higher than that of male （χ^2 =8. 26;P〈0. 005）. ②In the 25 patients with unilateral abnormalities, there were 19 cases with abnormalities in left lung, and only 6 cases with abnormalities in right lungo The abnormalities in left lung were more frequent than those in right lung （χ^2=6.76; P〈0.01）. In all cases, the abnormalities in left lower lobes （23/35, 65.7%） were more frequent when compared with the other lobes （χ^2= 15. 709;P〈0.01）. ③Areas of ground-glass attenuation on CT were identified in 97.1 % of the patients and their CT imaging characteristics included ground-glass attenuation becoming the large shadow of air-space consolidation gradually （71.4% ）, or scattered multiple patchy areas of air-space consolidation （74.3% ） in the ground-glass attenuation, or the above two patterns present in the same cases （48.6%）, or scattered multiple small nodular shadows in the ground-glass attenuation （68. 6%）. Pleural effusions and enlarged mediastinal lymph nodes were seen in 40.0 % and 28. 6% of the patients respectively. Conclusion The morbidity rate of Mycoplasma pneumoniae pneumonia in female was significantly higher than that in male and the abnormalities in the left lung more frequent than those in the right lung. The characteristics of its chest CT image can provide some hints for the diagnosis of Mycoplasma pneumoniae pneumonia.