儿童闭塞性细支气管炎HRCT表现

High resolution CT manifestations of bronchiolitis obliterans in children

目的：分析儿童闭塞性细支气管炎（B0）的HRCT表现，提高对该病的认识及诊断水平。方法：回顾性分析36例经临床诊断的B0患儿资料，其中男28例，女8例，年龄3个月～7岁，病程平均8个月。所有患者均行胸部HRCT检查，29例行支纤镜检查，1例行肺功能检查。结果：患者肺部的HRCT表现为：马赛克灌注征36例（100％）；支气管壁增厚30例（83％）；散在分布的斑点、斑片状模糊影27例（75％）；含气不全或实变不张11例（31％）；支气管扩张8例（22％）；微结节征4例（11％）；局部钙化灶2例（6％）。29例行纤维支气管镜检查显示气管、支气管内膜炎症。1例肺功能检查提示阻塞性通气功能障碍。结论：马赛克灌注征和支气管壁增厚是儿童闭塞性细支气管炎相对特征性的HRCT征象，结合患者临床上出现反复持续迁延进展的咳嗽、喘息、活动不耐受等，高度提示该病的可能。

Objective：We aimed to analyse the HRCT features of bronchiolitis obliteraris （BO） in children,and en-hance the diagnostic level of the disease. Methods： We retrospectively analyzed 36 cases of BO in children （including 28 boys and 8 girls） ,aged 3 months to 7 years,average duration of 8 months. All patients underwent HRCT examination, 29 cases were examined with fiber endoscopy,one with pulmonary function tests, Results sAll patients had characteristic HRCT find-ings as follows： mosaic perfusion in all cases （100 ~ ）, bronchial wall thickening in 30 cases （83 M） ,scattered spots or patch- y opacities in 27 cases （75 G ） ,incomplete aeration or consolidation and atelectasis in 11 cases （31% ） ~bronchiectasis in 8 ca-ses （22 %） ; micro-nodules sign in four cases （ 11 % ） ： localized calcification in two cases （6 %）. 29 routine fiber endoscopy showed endobronchial inflammation. One case had pulmonary function tests and the result was obstructive ventilatory dys-function. Conclusion： Mosaic perfusion and bronchial wall thickening on HRCT is relatively the specific characteristic of pe-diatric BO. Repeated and persistant coughing, wheezing,activity intolerance, ete, may be highly suggestive of BO.