胸部X线与低剂量CT在小儿肺炎支原体肺炎中的诊断价值及影像学表现分析OA
Analysis on the Diagnostic Value and Imaging Findings of Chest X-Ray and Low-Dose CT in Pediatric Mycoplasma Pneumoniae Pneumonia
目的 对比胸部X 线与低剂量 CT(LDCT)诊断小儿肺炎支原体肺炎(MPP)的临床价值,并分析两种检查方法在小儿 MPP中的影像学表现.方法 回顾性收集 2023 年 6 月至 2025 年 6 月在中国人民解放军联勤保障部队第九一〇医院就诊的100 例疑似MPP患儿的临床资料,入选患儿均先后完成胸部 X 线与 LDCT 检查.以临床综合诊断作为金标准,统计两种检查方法的诊断结果,计算诊断灵敏度、特异度、阳性预测值(PPV)、阴性预测值(NPV)及准确度;同时比较 MPP组、非 MPP组患儿的胸部X线与LDCT影像学表现.结果 金标准确诊 MPP阳性68 例,阴性 32例.胸部 X 线检查显示阳性 65 例,阴性 35 例,漏诊 11 例,误诊 8 例,LDCT 检查显示阳性 67 例,阴性 33 例,漏诊 3 例,误诊 2 例.LDCT 与胸部 X 线的诊断 PPV(97.01%vs.87.69%)比较,无统计学差异(P>0.05);LDCT 的诊断灵敏度、特异度、准确度及 NPV 分别为 95.59%、93.75%、95.00%、90.91%,均显著高于胸部 X 线的 83.82%、75.00%、81.00%、68.57%(P<0.05).影像学表现方面,MPP组胸部 X 线检查可见肺纹理增粗紊乱、斑片状浸润影、肺门影增大、边缘模糊占比高于非MPP组(P<0.05);MPP组 LDCT 检查可见肺实质影、小叶间隔增厚、树芽征、支气管壁增厚、胸腔积液、磨玻璃影占比高于非 MPP 组(P<0.05).结论 胸部 X 线操作简便、辐射剂量低,可作为小儿 MPP的初步筛查手段;LDCT能够更清晰显示肺部微小病变,诊断准确性更高.临床可根据患儿年龄、病情严重程度及诊疗需求合理选择影像学检查方法,必要时两者联合应用以提高诊断效能.
Objective To compare the clinical value of chest X-ray and low-dose computed tomography(LDCT)in the diagnosis of pediatric Mycoplasma pneumoniapneumonia(MPP),and to analyze the imaging findings of the two examination methods in pediatric MPP.Methods The clinical data of 100 children with suspected MPP who visited the 910th Hospital of Joint Logistics Support Force of PLA from June 2023 to June 2025 were retrospectively collected.All enrolled children underwent both chest X-ray and LDCT examinations sequentially.Taking the clinical comprehensive diagnosis as the gold standard,the diagnostic results of the two examination methods were tallied,and the sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy were calculated.Concurrently,the chest X-ray and LDCT imaging findings were compared between the MPP group and the non-MPP group.Results According to the gold standard,68 cases were confirmed positive for MPP and 32 cases were negative.Chest X-ray identified 65 positive cases and 35 negative cases,with 11 missed diagnoses and 8 misdiagnoses.LDCT identified 67 positive cases and 33 negative cases,with 3 missed diagnoses and 2 misdiagnoses.Comparison of diagnostic PPV between LDCT and chest X-ray(97.01%vs.87.69%)showed no statistically significant difference(P>0.05),whereas the diagnostic sensitivity,specificity,accuracy,and NPV of LDCT were 95.59%,93.75%,95.00%and 90.91%,respectively,all significantly higher than 83.82%,75.00%,81.00%and 68.57%of chest X-ray(P<0.05).Regarding imaging findings,the proportions of enhanced and disordered pulmonary markings,patchy infiltrates,enlarged hilar shadows,and blurred margins on chest X-ray were significantly higher in the MPP group compared to the non-MPP group(P<0.05);the proportions of parenchymal opacities,interlobular septal thickening,tree-in-bud sign,bronchial wall thickening,pleural effusion,and ground-glass opacities on LDCT were significantly higher in the MPP group compared to the non-MPP group(P<0.05).Conclusions Chest X-ray,being simple to perform and involving low radiation dose,can serve as a preliminary screening tool for pediatric MPP.LDCT enables clearer visualization of small pulmonary lesions,thereby offering higher diagnostic accuracy.Clinically,the appropriate imaging method should be reasonably selected based on the age,disease severity,and diagnostic and therapeutic needs of children.When necessary,combined application of the two methods can enhance diagnostic efficacy.
张宾;郭挺
中国人民解放军联勤保障部队第九一〇医院 儿科,福建 泉州 362000福建医科大学附属第二医院 儿科,福建 泉州 362000
医药卫生
小儿肺炎支原体肺炎低剂量CT胸部X线诊断价值影像学表现
Pediatric Mycoplasma pneumoniae pneumoniaLow-dose computed tomographyChest X-rayDiagnostic valueImag-ing finding
《临床医学工程》 2026 (5)
572-576,5
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