胸部平片、肺部超声、CT平扫在诊断儿童肺炎中的价值对比

Comparison on Value of Chest Plain Film,Lung Ultrasound and CT Plain Scan in the Diagnosis of Pneumonia in Children

目的探讨胸部平片、肺部超声、CT平扫在诊断儿童肺炎中的价值。方法选取我院2017年12月至2018年12月收治的儿童肺炎患者61例,均进行胸部平片、肺部超声、CT平扫检查,收集患者各项影像学资料,对比三种检查对儿童肺炎的诊断效能。结果胸部平片、肺部超声、CT平扫对儿童肺炎的诊断符合率及误诊率比较存在明显差异(P<0.05),CT平扫对儿童肺炎的诊断符合率最高,为100%,其次为胸部平片,为91.80%,肺部超声为86.89%,肺部超声对儿童肺炎的诊断误诊率为13.11%;肺炎胸部平片多呈现片状致密影,密度不均匀,边缘分界模糊。57例患者肺部超声出现多重或融合B线,外观形态为彗星尾征或火箭征,支气管壁出现增厚,局限性弱回声区,分界不清,内部短线样的强回声;CT平扫可见肺部纹理增多、增粗,出现磨玻璃影、网状影,伴支气管血管束增厚,13例患者出现纵膈淋巴肿大。结论胸部平片、肺部超声、CT平扫检查均能有效显示儿童肺炎典型图像特征,CT平扫对儿童肺炎诊断符合率最高,临床可根据患者个人情况选择检查方式。

Objective To explore the value of chest plain film,lung ultrasound,and CT plain scan in diagnosing pneumonia in children.Methods 61 children with pneumonia admitted to our hospital from December 2017 to December 2018 were enrolled.61 children with pneumonia were examined with chest plain film,pulmonary ultrasound,and CT scan.The patient’s imaging data were collected and the diagnostic efficacy of the three tests for children with pneumonia was compared.Results There was a significant difference in the diagnostic coincidence rate and misdiagnosis rate of chest plain film,lung ultrasound,and CT plain scan in children with pneumonia(P<0.05).CT scan has the highest coincidence rate for the diagnosis of children with pneumonia,was 100%,followed by chest plain film,91.80%,and lung ultrasound,86.88%.The rate of misdiagnosis of pulmonary ultrasound in children with pneumonia was 13.11%.The chest plain film of pneumonia often showed sheet-like dense shadow with uneven density and blurred boundaries.Ultrasound of the lungs in 57 patients showed multiple or fusion B-line,and the appea ra nce was the comet tail or rocket sign.The bronchial wall was thickened,there was a zone with localized weak echo,the bounda ry was unclea r,and there was a strong echo in the internal part like a short line.CT scan showed an increasing and thickening of in the texture of the lungs,showed grinding-glass shadow and mesh shadow,with thickening of the bronchial vascular bundle.Thirteen patients developed mediastinal lymphangoncus.Conclusion Chest plain film,pulmona ry ultrasound,and CT scans can effectively show the typical image cha racteristics of children with pneumonia.CT scan has the highest diagnostic rate for children with pneumonia.The clinical examination can be based on the patient’s condition.