小儿麻疹合并间质性肺炎的影像学分析

Imaging analysis of measles complicated with interstitial pneumonia in children

目的探讨小儿麻疹合并间质性肺炎的影像学表现,提高和重视对这一疾病的认识。方法回顾分析60例小儿麻疹合并间质性肺炎的临床资料以及X线和CT表现。结果①X线胸片:泡性肺气肿33例,其中伴右上肺斑点状,颗粒状较高密度影6例。肺门影增大、增浓56例。两肺纹理增多、模糊51例,其中密集的肺纹理使两肺透亮度减低17例,出现空气支气管征12例。间质性肺气肿16例。网状肺纹理32例。星芒、结节状影27例。两肺磨玻璃影11例。伴发小叶性肺炎13例,两肺单发或多发的片状实变影5例。其他表现:心影增大9例,气胸3例,纵隔皮下气肿4例,两侧少量胸腔积液8例;②10例CT检查结果:两肺大片磨玻璃影2例,实变影伴磨玻璃影3例,两肺纹理增多、模糊8例,两下肺纹理周围斑片状渗出5例。右下肺小叶间隔增厚2例,右下肺胸膜下弧线影1例,两下肺网格状、星芒状结节影2例。结论婴幼儿麻疹合并间质性肺炎的影像学表现应引起高度重视,早期发现和积极治疗有利于提高治愈率和改善患者预后。

Objective To discuss the imaging features of measles with interstitial pneumonia in Children in order to im- prove the understanding of this disease. Methods The clinical data, X-ray and CT findings of 56 cases of pediatric measles complicated with interstitial pneumonia were retrospectively analyzed. Results ① The findings of chest X-ray were as fol- lows. Bullous emphysema was found in 33 cases, of which 6 cases were accompanied with speckle or granular shadow in high density in right upper lung. The hilar shadow enlargement or thickening was found in 60 cases. The lung-marking was increased and fuzzy in two lungs in 51 cases, of which 17 cases presented with reduced transparency and 12 cases with air bronchogram. Pulmonary interstitial emphysema was found in 16 cases, the mesh lung-marking in 32 cases, and the nodular shadows in 27 cases. A large ground-glass opacity in two lungs was found in 11 cases. 13 cases presented with lobular pneumonia and 5 cases with solitary or multiple patchy consolidation in two lungs. The other imaging findings in- cluded cardiac enlargement in 9 cases, pneumothorax in 3 cases, pneumomediastinum subcutaneous emphysema in 4 cases; ② The CT findings of 10 cases were as follows. It was found that there were the large ground-glass opacity in two lungs in 2 cases, the consolidation images with ground glass opacity in 3 cases, the increased lur^g-marking and fuzzy in two lungs in 8 cases, and the pulmonary texture surrounding patchy effusion consolidation in 5 cases. The right inferior pulmo- nary lobular septal thickening was found in 2 cases and right lower pulmonary subpleural lines in 1 case, the two lower pul- monary astral form nodules in 2 cases, and less amount of pleural effusion in 8 cases. Conclusion Infant measles compli cated with interstitial pneumonia should be paid much attention to imaging findings. The early identification and aggressive treatment is beneficial to improve the cure rate and the prognosis of patients.