严重急性呼吸综合征无创通气胸部CT影像变化的研究  

Dynamic changes of pulmonary lesions on CT in patients with severe acute respiratory syndrome treated by non-invasivc positive pressure ventilation

作　　者：刘长柱[1] 程国英[1] 王仁贵[2] 刘月[1] 

机构地区：[1]北京市第六医院放射科,100007 [2]北京大学第一医院放射科

出　　处：《中华放射学杂志》2007年第5期479-482,共4页Chinese Journal of Radiology

基　　金：首都医学发展科研基金(2003-3091)

摘　　要：目的探讨严重急性呼吸综合征(SARS)患者使用无创通气后对胸部 CT 影像变化的影响及临床意义。方法回顾性分析18例 SARS 患者使用无创通气前及使用后(4～12 d)胸部 CT影像变化,并做远期(3～36个月)胸部 CT 随访。设未使用无创通气 SARS 患者27例为对照组。结果(1)使用无创通气18例患者中15例出现特殊 CT 表现:7例肺内实性病灶密度减低呈磨玻璃密度灶;5例肺下叶支气管血管束周围环形肺气肿;8例出现胸膜下肺气肿;2例出现纵隔气肿及气胸。远期随访(36个月)观察,2例患者残留胸膜下弧形线状影但有吸收。(2)对照组27例治疗过程中未出现上述 CT 表现。结论使用无创通气对 SARS 患者胸部 CT 影像表现产生影响,全面认识SARS 影像动态变化有利于合理使用无创通气治疗相关性肺炎。Objective To study the dynamic changes of pulmonary lesions of severe acute respiratory syndrome （SARS） treated by non-invasive positive pressure ventilation （NIPPV） on CT. Methods Serial chest CT images in 18 patients with SARS were retrospectively analyzed before and after NIPPV （4-12 days）, and a long-term follow-up （3-36 months） examination by CT was carried out. And 27 SARS cases without NIPPV were enrolled as the control group. Results （ 1 ） There were dynamic changes in 15 cases of 18 cases： partial multilobar consolidations of bilateral lungs changed into ground-glass opacities in 7 of 18 cases, a circular pulmonary emphysema around bronchial vascular strains of the lower lobes was seen in 5 of 18, subpleural pulmonary emphysema was seen in 8 of 18, pulmonary barotraumas were showed in 2 of 18. Residual of subpleural curvilinear shadow related to NIPPV was found in 2 cases on the follow-up scan. （2） Above changes on CT were not found in 27 cases without NIPPV. Conclusion There were changes of pulmonary lesions of SARS on CT related to NIPPV treatment, It is beneficial to assess the CT images in the NIPPV treatment of the related pneumonia in SARS.

关 键 词：严重急性呼吸综合征 体层摄影术 X线计算机 

分 类 号：R511.9[医药卫生—内科学] R816.4[医药卫生—临床医学]