Xiao Simin, Zeng Siyuan, Kou Yangbin
Radiology department, The First Affiliated Hospital of Traditional Chinese Medicine of Chengdu Medical College, XinDu Hospital of Traditional Chinese Medicine, Chengdu, China.
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Sci Rep. 2025 Mar 17;15(1):9162. doi: 10.1038/s41598-025-94006-0.
The aim of this article is to explore the lung characteristics and diagnostic value of X-ray and low-dose computed tomography (LDCT) in children with mycoplasma pneumoniae pneumonia (MPP). A total of 807 suspected children with MPP admitted to outpatient and inpatient departments from August 2023 to November 2023, were selected and divided into X-ray group (n = 389) and LDCT group (n = 418) according to the examination method. The two groups received chest X-ray examination and LDCT examination, respectively. Using pathogen detection results as the gold standard, we compared the imaging visible symptoms, diagnostic rate, sensitivity, specificity, diagnostic accuracy, and missed diagnosis rate of the two examination methods. In the LDCT, the main manifestations were thickened lung markings, patchy and striped shadows, followed by ground glass-like shadows, interstitial infiltration of the lungs, tree-in-fog sign, bronchial wall thickening, pleural thickening, consolidation/atelectasis, air bronchogram sign, and branching linear opacities (tree-in-bud sign). The main manifestations of X-ray were thickening of lung markings, followed by pulmonary patchy shadows, interstitial infiltration, and consolidation/atelectasis. LDCT scans revealed 359 cases of pediatric MPP, with 337 true positives cases, 22 false negatives cases, 23 false positives cases, and 36 true negatives cases. On the other hand, X-ray examinations identified 308 cases of pediatric MPP, with 266 true positive cases, 42 false negative cases, 35 false positive cases, and 46 true negative cases. The diagnostic rate, sensitivity, specificity and diagnostic accuracy of LDCT scans were 80.62%, 93.87%, 61.02% and 89.23%, which were higher compared to X-ray examinations, with the values of 68.38%, 86.36%, 56.79% and 80.21%. The missed diagnosis rate for LDCT was 6.13%, which was lower than the 13.64% rate for X-ray. LDCT demonstrated higher visibility of diagnostic rate, sensitivity, specificity and diagnostic accuracy compared to X-ray examinations, and the missed diagnosis rate of LDCT was lower than that of X-ray. Additionally, the radiographic features of LDCT were more characteristic, with simpler procedure, greater clinical utility.
本文旨在探讨X线及低剂量计算机断层扫描（LDCT）在儿童支原体肺炎（MPP）中的肺部特征及诊断价值。选取2023年8月至2023年11月在门诊及住院部收治的807例疑似MPP儿童，根据检查方法分为X线组（n = 389）和LDCT组（n = 418）。两组分别接受胸部X线检查和LDCT检查。以病原体检测结果作为金标准，比较两种检查方法的影像学可见症状、诊断率、敏感性、特异性、诊断准确性及漏诊率。在LDCT中，主要表现为肺纹理增粗、斑片状及条索状阴影，其次为磨玻璃样阴影、肺间质浸润、树芽征、支气管壁增厚、胸膜增厚、实变/肺不张、空气支气管征及分支状线性致密影（树芽征）。X线的主要表现为肺纹理增粗，其次为肺部斑片状阴影、间质浸润及实变/肺不张。LDCT扫描显示359例儿童MPP，其中真阳性337例，假阴性22例，假阳性23例，真阴性36例。另一方面，X线检查确诊308例儿童MPP，其中真阳性266例，假阴性42例，假阳性35例，真阴性46例。LDCT扫描的诊断率、敏感性、特异性及诊断准确性分别为80.62%、93.87%、61.02%及89.23%，高于X线检查，其值分别为68.38%、86.36%、56. .79%及80.21%。LDCT的漏诊率为6.13%，低于X线的13.64%。与X线检查相比，LDCT在诊断率、敏感性、特异性及诊断准确性方面具有更高的可见性，且LDCT的漏诊率低于X线。此外，LDCT的影像学特征更具特异性，操作更简单，临床实用性更强。
