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93例支气管肺发育 不良的影像学诊断 分析

作者:智月丽

所属单位:郑州大学附属儿童医院(河南省儿 童医院)呼吸科 (河南 郑州 450018)

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摘要

目的 研究早产儿支气管肺发育 不良(BPD)胸部X线和CT图像特征并探讨其 在BPD诊断和治疗中的应用价值。方法 回 顾性分析2015年8月至2018年8月我院93 例BPD患儿临床资料,根据氧依赖性将患 儿分为轻度(n=39)、中度(n=31)和重度 (n=23)三组并比较胸部X线和MSCT检查结 果。结果 轻度患儿X线肺野模糊和心影膈 面模糊比例及斑片影占比低于重度患儿, X线表现正常患儿比例高于重度患儿,差 异有统计学意义(P<0.05);轻度患儿CT图 像囊泡影及条片状致密影占比低于重度患 儿,差异有统计学意义(P<0.05)。结论 胸部X线和CT可为BPD早期发现和诊断提供 影像学支持,同时可作为评估病情轻重和 进展的主要依据,对指导BPD治疗和改善 患儿预后具有重要意义。

Objective To study the features of chest X-ray and CT images of bronchopulmonary dysplasia (BPD) in premature infants and to explore its application value in the diagnosis and treatment of BPD. Methods The clinical data of 93 children patients with BPD in our hospital from August 2015 to August 2018 were retrospectively analyzed. The children patients were divided into mild group (n=39), moderate group (n=31) and severe group (n=23) according to oxygen dependence,and the results and differences of chest X-ray and MSCT were compared among the groups. Results The proportions of X-ray blurred pulmonary field and blurred podoid and diaphragmatic surface and the ratio of plaque shadow in mild children patients were lower than those in severe children patients, and the proportion of children patients with normal X-ray performance was higher than that in severe children patients (P<0.05). The proportions of vesicle shadow and striped dense shadow on CT findings in mild children patients were lower than those in severe children patients (P<0.05). Conclusion Chest X-ray and CT can provide imaging support for early detection and diagnosis of BPD, and can be used as the main basis for assessing the severity and progress of BPD. And they are of great significance for guiding BPD treatment and improving the prognosis of children patients.

【关键词】支气管肺发育不良;早产儿; 影像学诊断;胸部X线;多层 螺旋CT

【中图分类号】R725.6;R445.3;R445.4

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2019.04.011

前言

影像学检查在支气管肺发育不良(bronchopulmonary dysplasia, BPD)早期诊断中占有重要地位,其中经典型BPD在校正胎龄36周时可 出现特征性X线表现,胸片检查结果虽然已不再作为评估病程严重程 度的指标,但结合病史对BPD早期诊断仍具有指导意义[1]。多层螺旋 CT(Multilayer spiral CT,MSCT)的发展和应用使肺部疾病诊断水平 明显提升,相较胸部X线可更清晰的显示肺部细小结构和间质改变,且 利用其强大的后期图像处理能力可更直观、立体地观察病灶形态、大 小及累及范围等特征,为BPD诊断和治疗提供准确参考依据[2]。本文主 要回顾性分析93例BPD患儿X线及MSCT图像特征,为提升BPD影像学检查 水平和早期辨识能力提供参考依据。