儿童重症手足口病的胸部X线及CT表现

目的探讨儿童重症手足口病胸部X线及CT表现特点。方法回顾性分析经临床确诊的重症手足口病53例患儿的胸部影像资料,均摄胸部X线平片,19例行CT检查。结果影像学表现可分为以下5种类型：（1）支气管炎型7例,主要累及肺间质;（2）局限型9例,病灶仅限于单个肺叶或肺段;（3）局限～广泛型21例,病变不仅累及单个肺叶或肺段,还可见跨越多个肺叶分布;（4）广泛型12例,病变累及双肺多个肺叶,广泛性分布;（5）肺水肿型（神经源性肺水肿）4例,病变累及双肺,以肺门为中心基本对称分布,典型者呈蝶翼状改变。结论重症手足口病的胸部X线及CT表现多种多样,以片絮状影及磨玻璃密度影为主,可合并肺间质性浸润,动态变化快,具有一定特征性。最终诊断需结合流行病学调查和实验室检查。

Chest radiologic and CT manifestations of children with severe hand-foot-mouth disease

Aim To explore the imaging features of chest radiograph and CT of children with secvere hand-foot-mouth disease（HFMD）.Methods Retrospective analysis of 53 clinically diagnosed severe HFMD child cases were examined with chest X-ray,19 cases underwent chest CT.Results The X-ray and CT findings of HFMD were characterized by 5 types：（1） Bronchitis type of 7 cases,mainly involving interstitial lung disease;2）Limited type of 9 cases with lesions limited to a single lobe or lung segment;3）Limited～diffue type of 21 cases with lesions not only involved a single lobe or lung segment,but also can be seen across multiple lung;4）Diffuse type of 12 cases with lung disease involving multiple lobes,extensive distribution;5）Pulmonary edema（neurogenic pulmonary edema）of 4 cases with lesions involving from the lung to the hilum as the central lesion in symmetric distribution,the typical person was Dieyi like to change.Conclusion The imaging features of chest radiograph and CT of severe HFMD varied,mainly with shadow and ground glass piece floc density image and they maight be complicated with pulmonary interstitial infiltration,dynamic changes quickly,which has a certain characteristic.However,the final diagnosis of HFMD still be based on epidemiology and laboratory examination.