【摘要】 目的 探讨儿童侵袭性肺部真菌感染(IPFI)的特征性高分辨率CT(HRCT)表现及表现差异的影响因素。方法 回顾性分析53例IPFI患儿的临床及影像资料,包括易感因素、免疫状态、肺部病灶类型、数目、分布规律及治疗后转归情况。组间差异性比较采用χ~2检验。结果 (1)53例IPFI患儿中肺炎相关者占47.2%,血液病者占43.4%,后者中性粒细胞缺乏发生率为100%。(2)98.1%的IPFI CT表现为肺部多发病灶,2种及以上病变形态共存者占64.2%。以实变(52.8%)、结节(49.1%)最常见,其次为磨玻璃密度灶(20.8%)、空洞(17%)、树芽征(13.2%)、晕征(9.4%)及新月征(3.8%)。非血液病患儿实变和磨玻璃密度灶的发生率(73.3%,33.3%)高于血液病患儿(26.1%,4.3%,P<0.05),而后者结节及晕征的发生率(73.9%,21.7%)高于前者(30%,0%,P<0.05)。结论 双肺多发实变、结节/肿块且多种形态并存是儿童IPFI的特征性CT表现。机体免疫状态及影像检查时间是HRCT表现差异的影响因素。更多还原

【Abstract】 Objective To investigate the high-resolution CT(HRCT) characteristics of invasive pulmonary fungal infections(IPFI) in children and the factors that influence the HRCT manifestatioms.Methods 53 children with IPFI were selected in this retrospective study,and their clinical and imaging data were analyzed including susceptible factors,immune status,and the types,number,distribution and outcome after treatment of the lung lesion.χ~2 test was used to compare the differences between different groups.Results(1) Among the 53 children with IPFI,47.2% of the cases were pneumonia-related,and 43.4% of the cases had blood diseases with 100% of neutrophil deficiency rate.(2)Multiple lesions were found in 98.1 % of IPFI,and 64.2% of them had two or more types of lesions.Consolidation(52.8%) and nodule(49.1 %) were the most common features,followed by glass-ground density(20.8%),void(17%),tree bud sign(13.2%),halo sign(9.4%) and monthly sign(3.8%).The incidences of consolidation and ground-glass opacity in children with non-blood disease(73.3% and 33.3%) were higher than those with blood disease(26.1 % and 4.3%,P<0.05),while the incidences of nodule and halo in the latter group(73.9% and 21.7%) were higher than those in the former group(30% and 0%,P<0.05).Conclusion Multiple consolidations and nodules/lumps coexist in the bilateral lung are the most common CT features for children with IPFI.Immune status and imaging examination time are two influence factors in different HRCT manifestations.更多还原