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[摘要] 目的 探討小儿肺炎支原体肺炎高分辨率CT影像学特点，为支原体肺炎患儿早期诊断及治疗提供依据。 方法 选取2018年1月至2019年12月佳木斯市妇幼保健院小儿肺炎支原体肺炎患儿52例，所有患儿均采用高分辨率CT影像诊断，总结病变分布特点、肺实质以及纵膈胸膜情况，分析支原体肺炎影像学特点与临床表现的关系。 结果 ≤3岁组支原体肺炎肺部于右肺、下侧分别为50.0%、45.8%，>3岁组右肺、下侧分别为53.6%、57.1%，在所有部位分布占比最高。影像学特点表现为支气管壁增厚及支气管充气，且≤3岁患儿磨玻璃样改变及散在斑片影分别为25.0%、66.7%，高于>3组患儿的10.7%、35.7%，差异有统计学意义（P<0.05）。>3岁组树芽征及肺实变分别为35.7%、53.6%，高于≤3岁组的25.0%、37.5%，差异有统计学意义（P<0.05）;分析影像学改变与病程的关系，发现患儿病程早期主要表现为树芽征与磨玻璃改变，发病后5～6 d会出现支气管壁增厚，胸腔积液症状及肺实变多发生在发病后10 d左右。 结论 高分辨率CT诊断小儿肺炎支原体肺炎，能够帮助明确病变位置，影像学特点表现为树芽征及支气管壁增厚充气，且与患儿病程具有一定的相关性，值得临床推广。

[关键词] 支原体肺炎;高分辨率CT;影像学特点;位置分布;磨玻璃样;支气管壁增厚

[中图分类号] R445.2          [文献标识码] B          [文章编号] 1673-9701（2021）13-0122-04

Analysis of high resolution CT imaging features of mycoplasma pneumoniae pneumonia in children

GE Xin

Department of Radiology， Jiamusi Maternal and Child Health Hospital in Heilongjiang Province， Jiamusi   154002， China

[Abstract] Objective To explore the imaging features of high resolution CT of mycoplasma pneumoniae pneumonia in children， and to provide the basis for early diagnosis and treatment in children with mycoplasmal pneumonia. Methods Fifty-two patients diagnosed with mycoplasma pneumoniae pneumonia in our hospital from January 2018 to December 2019 were enrolled in the study. High resolution CT was applied in all patients to summarize the lesion distribution characters， pulmonary parenchyma， and mediastinal pleura， and to analyze the relationship between imaging features and clinical manifestations of mycoplasma pneumonia. Results In the group of children aged ≤3 years old， the proportion of mycoplasma pneumoniae pneumonia in right lung and lower lung was 50.0% and 45.8% respectively; in the group of children aged >3 years old， the proportion of mycoplasma pneumoniae pneumonia in right lung and lower lung was 53.6% and 57.1% respectively， with the highest proportion of distribution in all parts. The imaging features were bronchial wall thickening and air bronchogram. The ground-glass-like changes and scattered patchy shadows in the group of children aged ≤3 years old （25.0% and 66.7% respectively） were higher than those in the group of children aged >3 years old （10.7% and 35.7% respectively）， with statically significant differences（P<0.05）. The tree bud sign and lung consolidation in the group of children aged >3 years old （35.7% and 53.6% respectively） were higher than those in the group of children aged ≤3 years old （25.0% and 37.5% respectively）， with statically significant differences （P<0.05）. The relationship between imaging changes and disease course was analyzed. It was found that tree bud sign and ground-glass-like changes were the main manifestations in the early stage of the disease. Bronchial wall thickening occurred 5-6 days after the onset of the disease. Pleural effusion and lung consolidation mostly occurred about 10 days after the onset of the disease. Conclusion High resolution CT diagnosis of mycoplasma pneumoniae pneumonia in children can help define the lesion location， of which the imaging features includes tree bud sign and bronchial wall thickening and inflation， with a certain correlation with the disease course， which is worthy of clinical popularization

[Key words] Mycoplasma pneumoniae pneumonia; High resolution CT; Imaging features; Location distribution; Ground-glass-like; Bronchial wall thickening

作为儿科常见的呼吸系统疾病，儿童支原体肺炎主要是因肺炎支原体感染引起的呼吸道及肺部炎症，在婴幼儿群体有着较高的发病率，患儿表现为不同程度咳嗽、发热、呼吸困难等，大部分患儿经过治疗预后良好，少数会发展为重症肺炎。流行病学调查研究发现，支原体肺炎以儿童及青年居多，但2岁以下儿童发生肺炎几率相对较低，呈现出地区流行特点，多在封闭环境、人员密集小范围环境爆发。2019年调查研究显示，住院儿童肺炎患儿中，支原体肺炎占10%～40%[1]。随着病情进展会累及到心血管及神经系统，若治疗不及时或治疗方案不当，将会导致持续高热，影响患儿健康成长，甚至威胁到患儿生命安全。现有研究……