支气管肺发育不良的CT表现

目的 观察支气管肺发育不良患儿胸部CT表现。方法 收集经临床确诊的支气管肺发育不良患儿42例,根据胎龄和吸入氧浓度分为轻、中、重度,均接受64层螺旋CT扫描及薄层重建,回顾性分析所有患儿的胸部CT表现。结果 胸部CT多表现为囊泡影(27/42,64.29%),双肺透光度减低、呈广泛或局部磨玻璃样改变(26/42,61.90%),条片状致密影(23/42,54.76%)及条索状、网格状、蜂窝状(16/42,38.10%);胸膜增厚4例,胸腔积液2例。囊泡影发生于双肺上下叶者15例(15/27,55.56%),其中10例发生于右肺中叶;仅发生于肺下叶者8例;仅发生于肺上叶者3例(3/27,11.11%);发生于双肺下叶及右肺中叶者1例。轻、中、重度支气管肺发育不良患儿中,囊泡影检出率分别为53.33%(8/15)、57.14%(8/14)、84.62%(11/13),差异无统计学意义(P=0.094);累及肺叶数(中位数)分别为1.0、1.5、4.0,差异有统计学意义(P<0.05)。结论 支气管肺发育不良常见的CT征象为囊泡影、局部或广泛磨玻璃影、致密影、条索状、网格状、蜂窝状影。囊泡影可发生于双肺,以肺下叶居多,胸膜下多见;囊泡影累及肺叶数越多,提示患儿临床表现越严重。

CT features of bronchopulmonary dysplasia

Objective To observe the chest CT features of bronchopulmonary dysplasia (BPD). Methods Totally 42 BPD children were collected. According to gestational age and inhaled oxygen concentration, all children were divided into mild, moderate and severe BPD, all cases underwent 64 MSCT and thin-slice CT reconstruction, and the imaging characteristics were retrospectively analyzed. Results In all cases, 27 cases (27/42, 64.29%) appeared as the capsule went up in smoke, pulmonary density decreased, presenting local or widely ground-glass opacity in 26 cases (26/42, 61.90%), 23 cases (23/42, 54.76%) appeared opacity, 16 cases (16/42, 38.10%) appeared funicular, grid or honeycomb lung. Pleural thickening was observed in 4 cases, and pleural effusion was observed in 2 cases. For the capsule went up in smoke, 15 cases (15/27, 55.56%) occurred in the upper and lower lobes of both lungs, including 10 cases occurred in the middle lobe of right lung, 8 cases (8/27, 29.63%) only occurred in the lower lobe, 3 cases (3/27, 11.11%) only occurred in the upper lobe, only 1 case occurred in the lower lobes of both lungs and the middle lobe of right lung. In the mild, moderate and severe BPD, the rate of the capsule went up in smoke was 53.33% (8/15), 57.14% (8/14), 84.62% (13/15) respectively, there were no significant difference (P=0.094). The average lobes (the median) involved was 1.0, 1.5, 4.0 respectively, there were significant differences (P<0.05). Conclusion The common CT manifestations of BPD are the capsule went up in smoke, local or widely ground-glass opacity, opacity, funicular, grid and honeycomb. The capsule went up in smoke develop in both lungs, given priority to the lower lobe, mostly in the subpleural. The more lobes involve, the clinical severity more heavier.