Objective To study the clinical manifestations and high resolution CT( HRCT) characteristics of bronchiolitis obliter-ans(BO) , so that to improve the understanding of it. Methods Clinical and CT data in 27 patients(22 boys and 5 girls, aged from 2 months to 5 years, and mean age 15. 4 months) with clinical confirmation of BO were retrospectively analysed. All the patients pres-ented with persistent cough and asthma. All cases underwent chest radiograph, HRCT examinations and blood gas analysis. 10 ca-ses and 5 cases underwent bronchoscopy and pulmonary function test, respectively. Results In 27 cases,24 cases were post-infec-tions BO and the others were premature infants after injury of lungs. Hypoxemia in 14 cases and respiratory failure in 4 cases were showed by blood gas analysis. Ten cases who underwent bronchoscopy showed chronic endobronchial infection. HRCT features in-cluded direct signs (peripheral bronchiectasis and bronchial wall thickening in 16 cases, centrilobular nodules in 5 cases) and indirect signs(bronchiectasis and bronchial wall thickening in 20 cases, air trapping signs in 5 cases, mosaic perfusion signs in 25 cases, con-solidation in 10 cases and atelectasis in 5 cases). Conclusion In most of the patients with BO present following infections. HRCT is of important value in the early diagnosis and evaluation of outcome of BO.%目的 探讨闭塞性支气管炎(BO)的临床表现与高分辨率CT(HRCT)特点,提高对本病的认识.方法 回顾性分析27例经临床诊断证实的儿童闭塞性细支气管炎的临床和CT资料,年龄2个月～5岁,平均15.4月,男22例,女5例.反复咳喘病程均在6周以上.27例患儿均行X线胸片,肺部高分辨率CT及血气分析.10例行电子纤维支气管镜检查,5例行肺功能检查.结果 27例确诊为BO患儿,3例为早产儿肺损伤后,余24例为感染后.血气分析示低氧血症14例,呼吸衰竭4例.10例行电子纤维支气管镜检查均提示有支气管内膜慢性感染.肺部高分辨CT检查,直接征象:外周细支气管扩张、管壁增厚(16例);小叶中心性支气管结节影(5例).间接征象:大支气管扩张、管壁增厚(20例);空气潴留征(5例)和马赛克灌注征(25例);肺实变(10例)、肺膨胀不全(5例).结论 儿童BO多为感染后起病,HRCT对该病的早期诊断及预后评价具有重要价值.
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