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目的总结小儿胸腺增大于透视下动态观察的变化特点,提高诊断与鉴别诊断能力。方法 100例患儿入院前X射线胸片均有可疑增大的胸腺影、但无典型胸腺影像学表现,为了鉴别诊断而实施了透视观察。结果 X射线胸片表现:类右上大叶性肺炎41例;右中上纵隔明显增宽19例;类似心影增大改变13例,右上纵隔肿块性改变17例,左上纵隔肿块性改变10例。透视表现:62例患儿深吸气时胸腺影完全回缩至纵隔内,38例患儿胸腺影明显向纵隔方回缩。21例肺炎患儿出院前复查胸片时,19例胸腺影无明显变化,2例胸腺影消失。结论患儿在深呼吸时胸腺的大小、位置及外形可有明显变化,如X射线胸片上有阴影需要鉴别是否为增大的胸腺时不必选择昂贵的高级检查,而应选择简单、易行的X射线透视为宜。
Objective To summarize the characteristics of dynamic changes of thymus in pediatric patients under fluoroscopy, and to improve the ability of diagnosis and differential diagnosis. Methods 100 cases of pre-admission X-ray chest X-ray suspicious cases of increased thymus, but no typical thymus imaging findings, for the differential diagnosis of the implementation of the perspective of observation. Results X-ray showed: 41 cases of right upper lobe pneumonia; the right middle superior mediastinum was significantly broaden in 19 cases; similar changes of the heart shadow increased in 13 cases, upper right mediastinal mass changes in 17 cases, left upper mediastinal mass changes in 10 cases . Perspective: 62 cases of children with deep inspiration thymus completely retracted to the mediastinum, 38 cases of thymus in children showed significant mediastinal retraction. 21 cases of children with pneumonia before discharge chest X-ray examination, 19 cases of thymus no significant change, 2 cases of thymus disappeared. Conclusion The size, location and appearance of the thymus in children with deep breathing may have obvious changes. For example, if there is a shadow on the X-ray chest to identify whether it is an enlarged thymus or not, it is not necessary to choose an expensive advanced examination. Instead, the simple and easy X Ray perspective is appropriate.