Yuan Xinyu, Yang Yang, Mou Jinghui, Liu Ming, Guo Hongwei, Zou Jizhen, Chen Huizhong
Radiology Department, Children Hospital Affiliated to the Capital Institute of Pediatrics, Beijing 100020, China.
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Zhonghua Er Ke Za Zhi. 2014 Apr;52(4):248-51.
To investigate the high-resolution computed tomographic (HRCT) features of infants with diffuse lung disease (DLD) for improving the diagnostic accuracy clinically.
Totally 75 infants under 2 years of age with DLD (2010-2013) were involved in this study. Among them, 56 were males and 19 females, aged from 2 days to 24 months (mean age was 10.9 months). According to the clinical or pathological data, the cases were enrolled into three groups, including systemic diseases-associated infantile DLD (30 cases), alveolar structure disorders-associated infantile DLD (23 cases), and infantile DLD specific to infancy (22 cases). Retrospectively, HRCT images, from the three groups respectively, were analyzed and compared. HRCT presentations including airway disorders, interstitial disorders and air space disorders were reviewed. Inter-reviewers consistency check was performed, the consistency between reviewers was good (K = 0.64;P = 0.03, < 0.05), as well as χ(2) test.
Among the three groups, some of the HRCT sings (bronchiectasis, thickened bronchiolar wall, mosaic sign, reticular, intralobular nodules and consolidations) had significant differences (χ(2) = 24.52, 6.08, 18.00, 12.56, 9.11 and 11.50, P < 0.05) .
The HRCT features of infantile pulmonary DLD/interstitial LD with different causes were as follows, compared to the other two groups, intralobular nodules was the main feature of the systemic diseases-associated infantile DLD, thickened bronchiolar wall, mosaic sign and consolidations were rare as well. Meanwhile, bronchiectasis was more common in alveolar structural disorders-associated infantile DLD, and reticular opacity was rarely seen. Associated clinical data, the HRCT presentations would help clinicians to make accurate diagnosis.
探讨弥漫性肺疾病（DLD）患儿的高分辨率计算机断层扫描（HRCT）特征，以提高临床诊断准确性。
本研究纳入2010年至2013年间75例2岁以下的DLD患儿。其中男56例，女19例，年龄2天至24个月（平均年龄10.9个月）。根据临床或病理资料，将病例分为三组，包括与系统性疾病相关的婴儿DLD（30例）、与肺泡结构紊乱相关的婴儿DLD（23例）和婴儿期特有的婴儿DLD（22例）。回顾性分析并比较三组患儿的HRCT图像。对HRCT表现，包括气道紊乱、间质紊乱和肺泡腔紊乱进行了评估。进行了阅片者间一致性检验，阅片者之间的一致性良好（K = 0.64；P = 0.03，<0.05），同时进行了χ(2)检验。
三组之间，部分HRCT征象（支气管扩张、细支气管壁增厚、马赛克征、网状影、小叶内结节和实变）存在显著差异（χ(2) = 24.52、6.08、18.00、12.56、9.11和11.50，P < 0.05）。
不同病因的婴儿期肺部DLD/间质性肺疾病的HRCT特征如下，与其他两组相比，小叶内结节是与系统性疾病相关的婴儿DLD的主要特征，细支气管壁增厚、马赛克征和实变也较少见。同时，支气管扩张在与肺泡结构紊乱相关的婴儿DLD中更常见，网状影少见。结合临床资料，HRCT表现有助于临床医生做出准确诊断。
