肺支气管发育不良(BPD)的低剂量128层螺旋CT(MSCT)影像评估

Low-dose 128-Slice Spiral CT( MSCT) Imaging Assessment of Pulmonary Bronchial Dysplasia( BPD)

目的:对小儿肺支气管发育不良的低剂量动态电子计算机断层扫描(Computed Tomography,CT)进行影像评估。方法:回顾性分析我院2008年8月~2017年9月收入的小儿肺支气管发育不良患儿临床资料,依据临床分级分为轻度组15例、中度组21例、重度组24例,在征得患儿家属知情同意下均实施低剂量动态CT扫描70,对其影像资料进行评估。结果:小儿肺支气管发育不良患儿CT表现分别为双肺透亮度降低、多发斑片状及纤维条索影、"磨玻璃"样改变、充气支气管征、支气管壁增厚、大小不一的囊状透亮影,轻度组占比依次为40%、26.67%、13.33%、6.67%、6.67%、6.67%,中度组占比依次为19.05%、9.52%、23.81%、19.05%、14.29%、14.29%,重度组占比依次为4.16%、4.16%、4.16%、29.17%、29.17%、29.17%,三者相比较,轻度组双肺透亮度降低、多发斑片状及纤维条索影2项占比>中度组>重度组,中度组充气支气管征占比>轻度组>重度组,重度组充气支气管征、支气管壁增厚、大小不一的囊状透亮影3项占比>中度组>轻度组,差异有统计学意义(P<0.05);三组迟发性呼吸系统损伤发生率、进展至临床第3/4期发生率相比较,轻度组<中度组<重度组,差异有统计学意义(P<0.05),住院治疗期间均未出现死亡病例,死亡率均为0%,差异无统计学意义(P>0.05)。结论:低剂量动态CT影像可准确评估小儿肺支气管发育不良严重程度并判断病情进展及临床转归提供可靠依据,值得在今后临床工作中推广使用。

Objective： To evaluate the low -dose dynamic computed tomography （CT） of pediatric bronchopulmonary dysplasia. Methods： The clinical data of children with bronchial dysplasia in our hospital from August 2008 to September 2017 were retrospectively analyzed. According to the clinical classification, 15 cases were divided into mild group, 21 moderate cases, and 24 severe cases. Under the informed consent of the family members, low - dose dynamic CT scans were performed to evaluate the image data. Results ： The CT manifestations of children with bronchopulmonary dysplasia were decreased lung luminosity, muhiple patchy and fibroin - like shadows, ＂ ground glass＂ - like changes, inflated bronchial signs, bronchial wall thickening, and sac of different sizes. In the light group, the light group accounted for 40% , 26. 67% , 13.33%, 6. 67%, 6. 67%, and 6. 67% in turn, and the medium group accounted for 19. 05%, 9. 52%, 23.81%, 19.05% , 14. 29%. The proportion of 14. 29% in the severe group accounted for 4. 16%, 4. 16%, 4. 16% , 29. 17%, 29. 17%, and 29. 17% , respectively. Compared with the three groups, the brightness of the lungs in the mild group was decreased, with muhiple patches and fiber strips. The proportion of 2 affected groups was 〉 moderate group 〉 severe group, the proportion of inflated bronchial lesions in moderate group 〉 mild group 〉 severe group, bronchial airway bronchogram, bronchial wall thickening, and cystic translucent shadows of different sizes in 3 groups. The proportions of the ratio 〉 moderate group 〉 mild group were statistically significant （ P 〈 0. 05 ） ; the incidence of delayed respiratory system injury＂ in the three groups was compared with the incidence rate in the 3rd/4th clinical stage, and the mild group was 〈 In the moderate group 〈 heavy group, the difference was statistically significant （ P 〈 0. 05 ）, and no deaths occurred during hospitalization. The mortality rate was 0%, and the difference was not statistically significant （ P 〉 0.05 ）. Conclusion： Low - dose dynamic CT images can accurately assess the severity of bronchopulmonary dysplasia in children and provide a reliable basis for jud- ging disease progression and clinical outcomes. It is worthy of promotion in clinical work in the future.