摘要
目的 探讨X线联合计算机断层扫描(CT)在小儿支原体肺炎(MPP)诊断中的应用及影像特点分析.方法 选取2021年1月-2023年7月收治的疑似118例小儿MPP作为研究对象,所有患儿均行X线和CT检查,以实验室检查作为"金标准",分析X线和CT检查以及对小儿MPP诊断价值.根据病情严重程度将MPP患儿分为重症MPP组(n=16)和轻度MPP组(n=83),比较两组X线和CT影像学表现.结果 X线联合CT检查的准确度高于X线和CT(93.22％vs 66.10％vs 84.75％,x2=29.947,P＜0.05);X线检查显示,小儿MPP主要表现为间质性浸润、肺门影增大、肺纹理增多、边缘模糊、大片影;小儿MPP主要表现为小叶中心结节、支气管壁增厚、磨玻璃影、支气管充气征、大片实变影;重症MPP组X线影像(间质性浸润、大片影)、CT影像(大片实变影、肺门淋巴结肿大、磨玻璃影、胸腔积液)占比高于轻度MPP组(P＜0.05).结论 MPP患儿X线主要表现为间质性浸润、肺门影增大、肺纹理增多,CT可清晰地显示大片实变影、肺门淋巴结肿大、磨玻璃影、胸腔积液,两者联合可提高对小儿MPP及其病情进展的诊断价值.
Abstract
Objective To explore the application and imaging characteristics of X-ray combined computed tomography(CT)in the diagnosis of Mycoplasma pneumoniae pneumonia(MPP)in children.Methods A total of 118 children with suspected MPP were enrolled as the research objects between January 2021 and July 2023.All underwent X-ray and CT examinations.Taking laboratory examination as the golden standard,diagnostic value of X-ray and CT for MPP was analyzed.According to disease severity,MPP children were divided into severe MPP group(n=16)and mild MPP group(n=83),and imaging findings of X-ray and CT in the two groups were compared.Results The diagnostic accuracy of X-ray combined with CT was higher than that of X-ray and CT alone(93.22％vs 66.10％vs 84.75％,x 2=29.947,P＜0.05).X-ray examination showed that the main manifestations in MPP children included interstitial infiltration,increased hilar shadow,increased lung texture,blurred edge and large shadow,while CT examination showed that the main manifestations in MPP children included central lobular nodules,thickening of bronchial wall,ground-glass opacity,air bronchogram and large solid shadow.The proportions of X-ray imaging(interstitial infiltration,large shadow)and CT imaging(large solid shadow,hilar lymph node enlargement,ground-glass opacity,pleural effusion)in severe MPP group were higher than those in mild MPP group(P＜0.05).Conclusion The X-ray manifestations in MPP children mainly include interstitial infiltration,increased hilar shadow and lung texture.CT can clearly display large solid shadow,hilar lymph node enlargement,ground-glass opacity and pleural effusion.X-ray combined with CT can improve the diagnostic value for MPP and its progression.
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