新生儿肺透明膜病的临床及影像学表现

Neonatal pulmonary hyaline membrane disease in the clinical And imaging manifestations

目的探讨新生儿肺透明膜病的(NHMD)影像学特征,以提高对本病的认识和诊断水平。方法选取我院经临床及病理证实的新生儿肺透明膜病45例,回顾性分析其影像学表现及临床特征。结果本组45例中,有细网状结节及颗粒样影表现者29例,有磨玻璃样影表现者35例,有片状、斑片状或大片状改变者31例。9例患者的心影、膈肌影模糊不清或完全消失。有支气管充气征表现者26例,呈白肺表现者7例,合并气胸者2例,合并纵膈气肿者1例。CR摄片中无明显异常,而CT上表现为双肺透光度稍低,肺野外围部分可见微小颗粒影者3例。35例复查病例中,17例在1～4天内呈不同程度的自Ⅰ级向Ⅳ级迅速发展,得到较明确诊断后给于治疗11例逐步好转,7例双肺呈"白肺"者最终治疗无效死亡;18例患儿诊断和治疗及时而病情稳定且逐步好转。结论新生儿肺透明膜病的影像学表现有一定的特征性,结合临床资料及动态变化特点,可及时准确发现本病,对临床预后及治疗有重要的价值。

Objective To investigate the eonatal pulmonary hyaline membrane disease （NHMD） imaging characteristics, toimprove the understanding and diagnostic level. Methods In our hospital were confirmed by clinic and pathology of 45 cases of neonatal hyaline membrane disease, a retrospective analysis of the imaging findings and clinical features. Results 45 cases in this group, there are fine mesh nodes and particles like shadows in 29 cases, a ground glass opacity manifestations in 35 cases, there was patchy, patchy or big shape changes in 31 cases. In 9 cases of pationts with heart,diaphragm shadow blur or disappear completely. There is air bronchogram Showed in 26 cases, white pulmonary manifestationsin 7 cases, 2 cases were complicated with pneumothorax, andpneumomediastinum in 1 cases. CR radiography showed no abnormalities, and the CT performance for the double lung transmittance slightly low, No peripheral portion of the visible particles of shadow in 3 cases. In 35 cases review cases, 17 cases in 1-4 days in different degree from I toNrapid development, obtained al^er Ming diagnosed for treatment of 11 patients with progressive improvement, 7 cases with double lung is ＂white lung＂ ultimately ineffective treaanent death; 18 cases were diagnosed and a＇eated in a timely fashion andillness stable and gradually improved. Conclusion Neonatal pulmonary hyaline membrane disease imaging findings are characteris-tic, combining the clinical data and the characteristic of dynamic change, can be timely and accurate detect-ion of the disease, the clinical prognosis and treatment have an important value.