增强CT对儿童坏死性肺炎的诊断价值

目的:研究增强CT上肺实变内出现无强化区是否可作为坏死性肺炎的诊断依据。方法:回顾性分析2016年8月至2018年9月在山东大学齐鲁儿童医院呼吸介入科住院的CT显示肺气囊的101例坏死性肺炎患儿(有气囊组)及CT未显示肺气囊但增强CT显示肺实变内出现无强化区的75例大叶性肺炎患儿(无气囊组)的临床资料，对2组患儿的检查...

Diagnostic value of enhanced CT for necrotizing pneumonia in children

Objective To study the diagnostic value of non-enhanced lesions on enhanced CT in lung consolidation for necrotizing pneumonia in children.Methods A total of 101 cases of necrotizing pneumonia with air sacs on CT scan who were hospitalized in the Department of Respiratory Intervention,Qilu Children′s Hospital of Shandong University from August 2016 to September 2018 were enrolled in this study(group with air lucency).Besides,another 75 cases of lobar pneumonia with non-enhanced lesions in lung consolidation but without air sacs on enhanced CT were also included from the same hospital over the same period(group without air lucency).Clinical data of these patients were retrospectively collected and statistically analyzed.Results The white blood cell count was(12.5±5.5)×10⁹/L in group with air sacs and(10.8±4.1)×10⁹/L in group without air sacs,and the difference was statistically significant(t=-2.161,P=0.032).There was no statistical difference between the group with and without air sacs in age,gender distribution,the course prior to admission,duration of fever after admission,length of hospital stay,medical expense,the neutrophils percentage in peripheral blood,C-reactive protein,the erythrocyte sedimentation rate,serum procalcitonin,serum D-Dimer,serum lactate dehydrogenase,serum albumin,bronchoscopy times,the bronchial mucosal erosion ratio,the mucus plug score,the lavage purulent lavage ratio,and the ratio of luminal stricture or atresia in late bronchoscopy(all P>0.05).Conclusions The clinical course of patients with non-enhanced lesions in lung consolidation but without air sacs is almost identical to that of patients with air sacs on CT scan.The presence of non-enhanced lesions in lung consolidation can be used as diagnostic basis of necrotizing pneumonia in children.