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目的探讨儿童重症手足口病胸部X线及CT表现特点。方法回顾性分析经临床确诊的重症手足口病53例患儿的胸部影像资料,均摄胸部X线平片,19例行CT检查。结果影像学表现可分为以下5种类型:(1)支气管炎型7例,主要累及肺间质;(2)局限型9例,病灶仅限于单个肺叶或肺段;(3)局限～广泛型21例,病变不仅累及单个肺叶或肺段,还可见跨越多个肺叶分布;(4)广泛型12例,病变累及双肺多个肺叶,广泛性分布;(5)肺水肿型(神经源性肺水肿)4例,病变累及双肺,以肺门为中心基本对称分布,典型者呈蝶翼状改变。结论重症手足口病的胸部X线及CT表现多种多样,以片絮状影及磨玻璃密度影为主,可合并肺间质性浸润,动态变化快,具有一定特征性。最终诊断需结合流行病学调查和实验室检查。
Objective To investigate the chest X-ray and CT features of severe hand-foot-mouth disease in children. Methods A retrospective analysis of 53 cases of clinically diagnosed critically ill hand-foot-mouth disease chest X-ray, chest X-ray, 19 cases of CT examination. Results Imaging findings can be divided into the following five types: (1) bronchiolitis in 7 cases, mainly involving the lung interstitium; (2) localized in 9 cases, the lesion is limited to a single lung or pulmonary segment; (3) limited ~ extensive Type in 21 cases, the lesion not only involved a single lobe or lung segment, but also seen across multiple lobe distribution; (4) a wide range of 12 cases, the lesions involving multiple lobes of the lungs, widespread; (5) pulmonary edema 4 cases of pulmonary edema, lesions involving the lungs, with hilar as the center of the basic symmetrical distribution, the typical was a wing-like changes. Conclusions The chest X-ray and CT findings of severe HFMD are diverse. The main symptoms are flaky shadow and ground glass density, which can be associated with pulmonary interstitial infiltration. The dynamic changes are fast and have certain characteristics. The final diagnosis should be combined with epidemiological and laboratory tests.