急性白血病患儿肺部感染诊断中薄层CT应用的评价

Clinical value of thin slice CT in diagnosis of pulmonary infections in children with acute leukemia

目的探讨急性白血病患儿肺部感染的薄层CT表现,提高薄层CT在诊断肺部感染中的价值。方法选取2005-2014年在医院确诊为急性白血病且住院期间患过肺炎的患儿120例,回顾性分析患儿肺部薄层CT的表现,总结急性白血病肺部感染的CT表现特点。结果 77例真菌性肺炎患儿以肺部结节或团块影为主要CT表现,占66.2%,其中有74.5%的结节或团块内出现了"新月征",56.9%结节或团块边缘出现了晕征;24例病毒性肺炎中,79.2%表现为双肺弥漫性改变,约50.0%病变呈现磨玻璃样改变;19例细菌性肺炎中有14例表现为肺叶或肺段的大片高密度影,63.5%合并支气管充气征。结论急性白血病患儿肺部感染的CT表现多种多样,真菌性肺炎是最常见的类型,CT表现为合并"新月征"和"磨玻璃晕征"的结节或团块影。

OBJECTIVE To explore the thin slice CT manifestations of the children with acute leukemia complicated with pulmonary infections so as to improve the value of thin slice CT in diagnosis of pulmonary infections . METHODS From 2005 to 2014 ,totally 120 children who were confirmed as acute leukemia and have suffered from pneumonia during the hospital stay were enrolled in the study ,then the thin slice CT manifestations of lungs of the children were retrospectively analyzed ,and the CT findings of the acute leukemia complicated with pulmonary in‐fections were summarized .RESULTS Of 77 children with fungal pneumonia ,66 .2% had the lung nodules or mas‐ses in the thin slice CT ,of whom 74 .5% appeared to air meniscus inside the nodules or masses ,and 56 .9% ap‐peared to halo sign around the edges of nodules or masses .Of 24 children with viral pneumonia ,79 .2% showed the diffuse lung changes ,of whom 50 .0% presented the ground‐glass opacities .Of 19 children with bacterial pneu‐monia ,14 showed the large high‐density shadow in the lung lobes or segments ,of whom 63 .5% presented the complication of air bronchogram .CONCLUSION The CT findings of the children with acute leukemia complicated with pulmonary infections are diversified;the fungal pneumonia is the most common ,and the complicated air me‐niscus and ground‐glass opacities in the nodules or masses are the CT findings .