儿童闭塞性毛细支气管炎影像学表现

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1、万方数据生垡越盟堂苤查!堂生!旦筮箜鲞筮!塑g!也』垦鲤丝：血垃!嫂i，!!!箜，盟生!儿童闭塞性毛细支气管炎影像学表现彭芸马大庆孙国强曾津津．小儿放射学．【摘要】目的探讨胸部x线片和薄层cT对儿童闭塞性毛细支气管炎(BO)的诊断价值。方法回顾性分析12例经临床诊断证实的BO患儿的资料，其中男9例，女3例，年龄5个月～11岁，所有患儿症状均持续6周以上。12例均行胸部前后位x线片、肺部薄层cT、纤维支气管镜、痰液、支气管肺泡灌洗液和肺功能检查，1例行肺灌注扫描。结果12例均有典型临床特征和肺功能不可逆性

2、小气道阻塞；1例肺灌注扫描示右下肺下段偏外侧放射性缺损低血流灌注表现；9例纤维支气管镜检为支气管内膜炎；4例活检病理提示慢性炎症。胸部x线片表现为：肺透光度增高8例；肺纹理增多，增粗6例；肺实变或不张6例；单侧或局限性透明肺4例。薄层cT表现为：“马赛克”征象，实质密度减低11例，血管细少10例；支气管扩张7例；支气管壁增厚9例；单侧或限局性透明肺4例。实质病变6例；结节征3例；支气管黏液栓5例。结论儿童BO的薄层cT表现比胸部x线片更具有特征性，诊断儿童BO可以基于临床表现、薄层CT和肺功能检查。【关

3、键词】细支气管炎，闭塞性；体层摄影术，x线计算机；儿童ClinicalandradiologicalfeaturesofbronchiolitisobliteransinchildrenPENGYun’．MADa—qing．sUNGuo—qiang。zENGJ讯-ji,L‘ImagingCenter，BeijingChildrentSHospitalAffiliatedtoCapitalUniversityofMedicalSciences．100045Beijing．China【Abstract】0b

4、jectiveTostudythevalueofchestradiographandthin-sectioncomputedtomography(CT)indiagnosisbronchiolitisobliteransinchildren，andtodetermineclinicalviewofobliterativebronchilitisinchildren．MethodsWeidentified12infants，10boys，and2girls(agerange，5monthto1years)

5、withclinicalconfirmationofbronchiolitisobliterans．ThreecaseswereafterSteven—Johnsonsyndrome．8werepost．infection(2adenovirus，2measlesand1Pseudomonasaeruginosainfection，3caseswereunknownetiologyinfection)：Thesymptomslastedforatleast6weeks．Onecasehadlungven

6、tilationnuclearscan．Weeva]uatedindividualbronchscopy，pulmonaryfunctiontest．chestradiographandtIlin—sectionCTfeaturesandtheircharacteristicappearance．ResultsA1lCaseshadtypicalclinicalcharacteristicsandpulmonaryfunctiontestingresultsthatwereconsistentwitll

7、nonreversiblesmallairwaysobstruction．Onecasehadlungventilationnuclearscanillustratedabsentandreducedventilationoftherightlowerlobe．Ninecaseswhounderwentbronchoscopywerechronicendobronchialinflammation．田lreechildrenhadtransbronchialbiopsyand1patientwhound

8、erwentopenpulmonarybiopsieswereuncertainofhistologicaldiagnosis．Chestradiographyshowedhyperinflationin8cases；peribronchialthickeningin6cases：consolidation／atelectasiain6cases：unilateralhyperlucencyofasmall／normal-sizedlung