新生儿肺透明膜病的影像诊断

Imaging Analysis of Pulmonary Hyaline Membrane Disease in Newborns

目的探讨新生儿肺透明膜病的影像特征,提高对本病的认识和早期诊断能力。方法回顾性分析经临床及病理证实的105例新生儿肺透明膜病的X线表现。结果本组105例中27例表现为肺野肺透光度下降及呈弥漫颗粒状阴影;33例表现为肺野透光度减低、斑片状密度阴影;26例肺野透光度明显下降,广泛斑片状阴影,心缘及膈面模糊;19例肺野呈均匀致密影,称为"白肺"。其中合并肺炎24例,肺出血13例,动脉导管未闭19例,气胸7例,缺氧缺血性脑病(HIE)11例。结论新生儿肺透明膜病的影像表现各种各样,其中磨玻璃征、肺纹理被掩盖不能分辨和支气管充气征在本病中具有特征性表现。普通X线检查和结合临床是诊断新生儿肺透明膜病的可靠方法。

Objective To investigate the imaging features of pulmonary hyaline membrane disease（HMD） in newborns and to improve the early diagnostic ability.Methods X-ray findings of 105 newborns with clinically and pathologically proved HMD were analyzed retrospectively.Results Twenty-seven cases of 105 newborns with HMD had fine reticular changing and diffuse granular opacities in the lung field,33 cases had decreased hyalinization of lung field,mottling shadows with high density,and 26 cases cardiac border and diaphragmatic face hazy.ninteen cases presented as ＂white lung ＂,of whom,24 cases were complicated with pneumonia,19 cases were complicated with pulmonary hemorrhage,and 13 cases had patent ductus arterious,7 cases were complicated with pneumothorax and 11 cases hypoxic ischemic encephalopathy（HIE）.Conclusion There are various images of HMD in newborns.Ground glass opacity of the whole lungs and pulmonary grain concealed and the aerial bronchogram are three characteristic findings of HMD.Conventional X-ray chest radiography combining the clinical symptoms is considered the most reliable diagnostic tool in HMD diagnosis in newborns.