胸部CT对儿童不同病原菌感染肺炎的鉴别诊断价值

The Differential Diagnosis of Chest Computed Tomography on Differen Pathogenic Bacteria Pneumonia in Children

目的:对比观察肺炎支原体肺炎和肺炎支原体合并链球菌属感染肺炎患儿的胸部CT表现差异,探讨胸部CT对儿童不同病原菌感染肺炎的鉴别诊断价值。材料与方法:收集30例单纯肺炎支原体肺炎患儿(A组)和30例肺炎支原体合并链球菌属感染肺炎患儿(B组),两组患儿均行胸部CT扫描,对比观察两组患儿的胸部CT表现。结果:A组患儿胸部CT征象网状影、磨玻璃影、支气管血管束增厚、支气管壁增厚出现率显著高于B组,差异有统计学意义(P<0.05),两组支气管充气相和肺气肿出现率比较差异无统计学意义(P>0.05);两组患儿胸部CT肺内病变形态比较差异有统计学意义(P<0.05),A组患儿主要表现为扇形分布的薄片影,B组患儿主要表现为无规律的肺内实变影;A组患儿胸腔积液发生率低于B组,胸腔积液厚度小于B组,差异均有统计学意义(P<0.05),两组均能发现肿大淋巴结影,但A组淋巴结最大横径平均值小于B组,差异有统计学意义(P<0.05)。结论:肺炎支原体肺炎和肺炎支原体合并链球菌属感染肺炎胸部CT表现不同,胸部CT能够起到很好的鉴别作用。

Purpose： To observe the chest CT performance differences between mycoplasma pneumoniae pneumonia and sreptococcus pneumonia mycoplasma pneumoniae merger in children, to explore the differential diagnosis of chest compu- ted tomography on different pathogenic bacteria pneumonia in children. Materials and Methods： Collected 30 cases children with mycoplasma pneumoniae pneumonia alone （group A） and 30 cases children with mycoplasma pneumoniae merge infection of streptococcus pneumonia （ group B）, children in two groups were with chest CT scan, observed the chest CT performance between two groups. Results： The rate of mesh shadow, ground glass shadow, thickening of bronchial neurovascular bundle posteriorly and bronchial, wall thickening in group A were significantly higher than group B, the difference was statistically sig- nificant （ P 〈 0. 05 ）, there were no differences of air-filled bronchi and pulmonary emphysema between two groups （ P 〉 0. 05 ） ; there was significantly difference of chest CT pulmonary lesions within the form between two groups, Children in group A was mainly fan-shaped distribution of thin film, group B with main show was irregular in lung consolidation shadows ; The in- cidence of pleural effusion in group A was significantly lower than group B, pleural effusion thickness was less than group B, the difference was statistically significant （ P 〈 0. 05）, two groups all could find swollen lymph nodes, but lymph node average maximum transverse diameter in group a was less than group B, the difference was statistically significant （ P 〈 0. 05 ）. Con- clusion： Mycoplasma pneumoniae pneumonia mycoplasma pneumoniae and merge infection of streptococcus pneumonia chest CT manifestations, chest CT can have very good identification effect.