Neonatal Intensive Care Unit, Affiliated Hospital of Jining Medical University, Jining, Shandong, China (mainland).
Neonatal Intensive Care Unit, Women and Children Health Institute Futian, University of South China, Shenzhen, Guangdong, China (mainland).
Med Sci Monit. 2018 Oct 15;24:7375-7381. doi: 10.12659/MSM.911749.
BACKGROUND The aim of this study was to investigate the diagnostic value of multi-slice spiral computed tomography (MSCT) for bronchial dysplasia in premature infants. MATERIAL AND METHODS A retrospective analysis of 248 premature infants who were highly suspected to have bronchial dysplasia and were admitted to our hospital from 2015 onwards was conducted. We observed bronchus morphologies, sizes, and tissue characteristics using fiberoptic bronchoscopy (FB) as the criterion standard for diagnosis. We calculated the sensitivity, specificity, and diagnostic compliance of MSCT in the diagnosis of bronchial dysplasia. RESULTS Thoracic computed tomography mainly revealed capsular bubbles. The translucency of the 2 lungs was reduced, and extensive and local ground-glass changes were observed. Imaging findings mostly included strip or honeycomb-like shadows. Pleural thickening and pleural effusion were rare. MSCT was able to establish a diagnosis in 92 cases (37.10%) of bronchopulmonary cysts, 69 cases (27.82%) of congenital pulmonary emphysema, 31 cases (12.50%) of bronchial atresia, 1 case (0.40%) of congenital cystadenoma malformation, and 3 cases (1.21%) of giant tracheal bronchitis. Another 52 children (20.97%) were found to have conventional pulmonary inflammation. The sensitivity of MSCT in the diagnosis of bronchial dysplasia was 88.21%, the specificity was 75.00%, and the diagnostic compliance was 86.29%. There was a significant difference between the MSCT and FB findings in the diagnosis of bronchial hypoplasia (P<0.001). CONCLUSIONS MSCT has great utility in the diagnosis of bronchial dysplasia in premature infants and may become an excellent method for diagnosing bronchial dysplasia in the future.
本研究旨在探讨多层螺旋 CT(MSCT)对早产儿支气管发育不良的诊断价值。
回顾性分析 2015 年以来我院收治的 248 例高度疑似支气管发育不良的早产儿。以纤维支气管镜(FB)检查结果为诊断金标准,观察支气管形态、大小及组织特征。计算 MSCT 对支气管发育不良的诊断敏感度、特异度和诊断符合率。
胸部 CT 主要表现为肺气囊影,双肺透亮度降低,可见弥漫性或局限性磨玻璃影,影像学表现多为条片状或蜂窝状影,胸膜增厚及胸腔积液少见。MSCT 诊断肺囊腺瘤样畸形 1 例(0.40%),先天性肺囊性腺瘤样畸形 1 例(0.40%),先天性肺大泡 69 例(27.82%),支气管闭锁 31 例(12.50%),巨气管支气管症 3 例(1.21%),单纯性肺间质炎症 52 例(20.97%)。MSCT 对支气管发育不良的诊断敏感度为 88.21%,特异度为 75.00%,诊断符合率为 86.29%。MSCT 与 FB 对支气管发育不良的诊断结果比较,差异有统计学意义(P<0.001)。
MSCT 对早产儿支气管发育不良的诊断有重要价值,可能成为未来诊断支气管发育不良的一种优秀方法。