儿童腺病毒肺炎CT影像表现特点

CT image feature of human adenovirus pneumonia in children

目的探讨儿童腺病毒肺炎胸部CT检查影像表现的特点。方法选取并分析确诊的30例儿童腺病毒肺炎的临床及影像资料,对CT征象特点进行统计分析。结果CT表现肺实质改变患儿30例,其中22例为双侧受累,21例受累肺叶数≥3,20例肺部病变形态表现为磨玻璃影,24例为斑片状实变影,两者互为重叠;21例为实变向心分布,其中16例实变呈团簇状影;26例见空气支气管征,24例有肺间质改变,3例为肺过度充气,1例出现空洞,4例合并肺不张,4例见支气管狭窄,14例见树芽征,4例胸膜增厚,3例胸腔积液,4例有淋巴结肿大。3例患儿在临床治疗过程或者治疗后的随访过程中出现小气道改变。1例治疗过程中病情加重死亡。18例合并支原体感染。结论儿童腺病毒肺炎的胸部CT影像特点为双肺多肺段肺实变,肺实变多呈团簇状、向心分布,常合并间质改变;合并支原体感染时,树芽征明显。在特定好发季节,结合影像可以提示诊断。

Objective To discuss the features of chest CT images of children with human adenovirus pneumonia.Methods The clinical and imaging data of 30 children with adenovirus pneumonia were analyzed retrospectively,the features of CT signs were analyzed statistically.Results The chest CT scan showed 30 patients with pulmonary parenchymal changes,including 22 patients with bilateral involvement,21 patients with affected lung lobes≥3;ground-glass opacity was found in 20 patients,patchy consolidation was found in 24 patients,they overlaped each other;consolidated and centripetal distribution was found in 21 patients,including 16 patients of consolidation showing cluster shadows;pulmonary interstitial change was found in 24 patients,pulmonary hyperplasia was found in 3 patients,cavity was found in 1 patient,atelectasis concurrent was found in 4 patients,bronchial stenosis was found in 4 patients,tree bud sign was found in 14 patients,pleural thickening was found in 4 patients,pleural effusion was found in 3 patients,and lymphadenectasis was found in 4 patients.3 patients were found small airway changes during clinical treatment process or post-treatment follow-up.One subject’s conditions was got worsened and died during treatment.Mycoplasma concurrent infection was found in 18 patients.Conclusion The chest CT images of human adenovirus pneumonia in children are characterized by lung consolidation in multiple pulmonary segments in both lungs.Lung consolidation is mostly cluster-like,centripetal distribution,as a rule concurrent pulmonary interstitial change;tree bud sign can be more observed when the patient is infected with mycoplasma.In specific season,combined with imaging,the diagnosis can be prompted.