小儿支原体肺炎54例胸部CT影像分析

Image analysis of chest CT of 54 children with mycoplasma pneumonia

目的分析总结小儿肺炎支原体肺炎(MPP)胸部CT影像学特点。方法回顾性分析本院儿科2010年9月—2011年2月间明确诊断的54例MPP患儿的临床资料及胸部CT。结果胸部CT显示病变部位:单侧者39例(72.22%),双侧者15例(27.78%);单侧中右侧者20例(51.28%),左侧者19例(48.72%);多个叶段受累30例(55.56%)多于单个叶段受累24例(44.44%),各受累叶段分布情况为:右下叶18例(33.33%),左下叶15例(27.78%),左上叶11例(20.37%),右上叶7例(12.96%),右中叶7例(12.96%),左中叶2例(3.70%);病变性质显示为大片实变影31例(57.41%),斑点状及斑片状实变影22例(40.74%),云絮状或磨玻璃样或网格样密度增高影各1例(1.85%),双肺散在斑片影7例(12.96%),其中非单个叶段受累者大片实变与斑点状及斑片状实变多同时存在。其他病变还有胸腔积液14例(25.93%),肺门淋巴结肿大7例(12.96%),肺不张7例(12.96%),心包积液1例(1.85%)。婴幼儿MMP胸部CT以散在斑片影为主,年幼儿以斑点状及斑片状实变影为主,年长儿则多表现为大片实变影。结论小儿MPP单侧病变多于双侧,右肺病变多于左肺,大片实变影最多,其次为斑点及斑片状实变影,也可见双肺散在斑片影。其影像学特点与年龄有关。胸部CT影像学特点有助于婴幼儿及年幼儿MPP的诊断及儿童MPP的早期诊断。

Objective To analyze and summarize the chest CT imaging features of mycoplasma pneumoniae pneumonia（MPP） in children.Methods The chest CT scans and clinical data of 54 cases with MPP from September 2010 to February 2011 were retrospectively analyzed.Results There were 39 cases（72.22%） with abnormalities in the unilateral and 15 cases（27.78%） with abnormalities in the bilateral.In these cases with unilateral abnormalities,there were 20 cases（51.28%） with abnormalities in right lung and 19 cases（48.72%） with abnormalities in left lung.Multiple areas abnormalities（30 cases,55.56%） were more than single areas（24 cases,44.44%）.There were 18 cases of the abnormalities in right lower lobes（33.33%）,15 cases of the abnormalities in left lower lobes（27.78%）,11 cases of upper lobe of left lung（20.37%）,7 cases of middle lobe of right lung or 7 cases of upper lobe of right lung（12.96%）,2 cases of middle lobe of left lung（3.70%）.A large area of consolidation on CT was identified in 31 cases（51.41%）,the mottling or patchy consolidation were identified in 22 cases（20.74%）,and scattered patchy shadows in 7cases（12.96%）.The other CT imaging features included pleural effusion（25.93%）,hilar lymph node enlargement（12.96%）,atelectasis（12.96%）.The scattered patchy shadows were presented on CT of the infant with MMP.The mottling or patchy consolidation were presented on CT of the younger children with MMP.The large area of consolidation was presented on CT of the older children with MMP.Conclusion The abnormalities in unilateral were more frequent than those in the bilateral.The abnormalities in the right lung were more frequent than those in the left one.The large area of consolidation was most frequent in all cases.The secondly were mottling or patchy consolidation,the scattered patchy shadows were also presented.CT imaging features was different in children of different ages.The features of chest CT image can provide some hints for the diagnosis and treatment of MPP in children.