小儿支气管肺炎的X线检查与影像分析

X-ray examination and imaging manifestation of bronchial pneumonia in children

目的总结120例小儿支气管肺炎的X检查方法及特征影像表现,为临床提供客观诊断依据。方法回顾性收集120例年龄3个月至5岁患儿,临床诊断支气管肺炎,X线胸片明确肺部病灶,经治疗后X线胸片复查,病灶完全或基本吸收的病例。结果本组120例患儿,男性68例,女性52例;3个月至1岁23例,1至3岁58例,3至5岁39例;左肺下叶29例,右肺上叶8例,右肺中叶23例,右肺下叶42例,双肺18例;肺纹理异常,表现为肺纹理增多、增粗,纹理间散在小点状阴影,肺门影模糊的间质性改变为特点44例;中下肺野内中带不规则斑片状、花蕾状散在分布浸润性阴影49例;小叶性密度不均匀实变16例;局灶性肺小叶过度充气11例。结论肺纹理增粗、增多、模糊的影像表现与网状及小点状密度增高影并存,是支气管、支气管周围炎及其邻近间质性炎性病变的复合影像表现,细支气管及肺泡炎性渗出所致的斑片状、花蕾状浸润阴影是支气管肺炎的典型表现。

Objective Summarize X-ray inspection method and the image characteristics of 120 cases with bronchopneumonia of children, to provide the objective diagnostic basis for clinical. Methods Retrospectively collect 120 patients aged from 3 months to 5 years old, with clinical diagnosis of bronchial pneumonia and X-ray chest radio- graph showing lung lesions, all cases underwent X-ray chest radiograph review after treatment, which showed lesions were partly or completely absorbed. Results Of 120 cases, there were 68 cases of male and 52 females ,and there were 23 cases aged from 3 months to 1 year old, 58 cases aged from 1 to 3 years old and 39 cases aged from 3 to 5 years old; 29 cases, lesions located in left lower lobe, 8 cases in the upper lobe of right lung and 23 cases in the middle and 42 cases in lower lobe.Double lungs were involved in 18 cases. By X-ray chest radiograph,44 cases showed that pulmonary vein were with abnormalities, which characterized by increased pulmonary texture, enlarge- ment, scattered in the small dot between texture shadows, and lung door shadow vague interstitial change; 49 cases showed that invasion shadow were with irregular patchy, bud shape scattered in the middle and lower lung field; 16 cases showed as lobular uneven density uniform change and 11 cases with excessive air in focal pulmonary lobules. Conclusion The imaging performance that pulmonary vein with enlargement and being increased was in concomitance with fuzzy, mesh and small dot density increase, which is composite image manifestation of interstitial inflammatory lesions of bronchi or around the bronchia. Alveolar inflammatory exudation of patchy, bud form infiltration caused by shadows are a typical manifestation of bronchial pneumonia.