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为探讨常用的各种影像学检查在儿科肺部间质性病变诊断中的价值 ,特别是高分辨率CT(HRCT)在间质性病变诊断中的意义。将45例(间质性肺炎21例 ,郎格罕组织细胞增生症12例 ,致纤维化肺泡炎4例 ,特发性肺含铁血黄素沉着症8例)患儿的普通X线胸片、常规CT片及HRCT片进行回顾性比较、分析 ,并对普通X线胸片和HRCT ,以及常规CT和HRCT的结果进行一致性和差异性检验。结果 :①HRCT对肺内网状阴影、小结节状阴影、肺气肿和细支气管病变的显示率均超过50% ,网状阴影显示率高达86.7% ;常规CT扫描和普通胸片对以上征象的显示率则较低 ,特别是对于磨玻璃样阴影和细支气管病变的显示率更低。②HRCT与普通X线胸片及常规CT比较 ,在显示肺内网状阴影、小结节阴影(直径<1cm)、肺气肿、细支气管病变及磨玻璃样阴影时 ,结果具有显著或非常显著一致性(P<0.05,<0.005);对肺内网状阴影、小结节阴影、磨玻璃样阴影、肺气肿和细支气管病变的阳性显示 ,HRCT与普通X线胸片及常规CT比较 ,差异有非常显著意义(P<0.005)。提示HRCT在显示儿科肺部间质性病变的网状阴影、小结节阴影、磨玻璃样阴影、肺气肿和细支气管病变时优于常规CT和普通X线胸片 ,可在病情判断及疗效观察等方面为临床提供更大的帮助
In order to explore the value of various commonly used imaging examination in the diagnosis of pulmonary interstitial lesions in children, especially high-resolution CT (HRCT) in the diagnosis of interstitial lesions. A total of 45 cases (interstitial pneumonia in 21 cases, 19 cases of Langerhans cell histiocytosis in 12 cases, 4 cases of fibrosing alveolitis, idiopathic pulmonary hemosiderosis in 8 cases) children with ordinary chest X-ray , Conventional CT and HRCT were retrospectively compared and analyzed, and the results of conventional X-ray and HRCT, as well as conventional CT and HRCT consistency and difference test. Results: ①HRCT showed more than 50% reticular shadows, small nodular shadows, emphysema and bronchioles lesions, and the reticular shadow showed a high rate of 86.7%. Conventional CT scans and ordinary chest radiographs of these signs Of the display rate is lower, especially for glassy shadows and bronchial lesion showed a lower rate. ②HRCT compared with the common chest X-ray and conventional CT, the results showed significant or very significant in showing the reticular shadow in the lung, the nodular shadow (diameter <1cm), emphysema, bronchioles lesions and ground glass-like shadow (P <0.05, <0.005). The positivity of reticular shadow, nodular shadow, ground-glass shadow, emphysema and bronchioles lesions in lung showed that HRCT was significantly lower than that of plain chest X-ray and conventional CT , The difference is very significant (P <0.005). Tip HRCT in pediatric pulmonary interstitial lesions showed reticular shadow, nodular shadow, ground glass-like shadow, emphysema and bronchial lesions than conventional CT and plain X-ray, in the judgment of the disease and Efficacy and other aspects of clinical observation to provide greater help