肺撕裂伤的螺旋CT诊断  

Spiral CT Diagnosis of Pulmonary Laceration

作　　者：王之平 许永明 

机构地区：[1]温岭市第一人民医院CT/MR室,浙江温岭317500

出　　处：《实用放射学杂志》2011年第4期522-525,共4页Journal of Practical Radiology

摘　　要：目的 分析肺撕裂伤的螺旋CT表现.方法 29例肺撕裂伤患者,均于伤后1～4 h急诊行CT检查,16例分别于伤后1～3 d,4 d～3周,3周后CT复查.结果 29例肺撕裂伤共38个病灶,右肺单发12例,多发3例,左肺单发10例,多发1例,双肺多发3例.急诊首次CT表现：（1）单发气囊腔3个,液气囊腔10个;（2）多发液气囊腔7个;（3）大片肺出血或大片湿肺内单发或多发低密度气囊12个;（4）单纯肺血肿3个;（5）血肿内泡状积气3个.所有病灶周围均见斑片状、云絮状或晕形磨玻璃样影.16例复查CT表现：（1）1～3 d复查,气囊腔内出现液平;液气囊腔内液体增多;肺出血范围缩小,形成边界清晰肺血肿.病灶周围磨玻璃样影逐渐吸收.（2）4 d～3周复查,16例中有8例变为血肿形态,边界清楚;3例液气囊腔缩小,液平消失,呈厚壁囊腔;5例病灶形态变化不大.所有病灶周围磨玻璃样影缩小、消失.（3）3周后复查,气囊、液气囊缩小,消失;大片肺出血内多发气囊及液气囊完全消失;肺血肿缩小,边界清晰;小血肿吸收消散,残留条索状影;有3例肺血肿半年后复查仍未吸收,表现为肺内肿块.结论 螺旋CT是诊断和动态观察肺撕裂伤的最佳方法.气囊腔,气液囊腔,肺血肿及病灶周围磨玻璃样影是诊断肺撕裂伤的重要征象.Objective To analyze the spiral CT features of lung laceration. Methods 29 patients with lung laceration were examined by spiral CT in 1--4 hours after injury. 16 cases of them were followed-up in 1--3 days,4 days--3 weeks and 3 weeks later respectively after injury. Results There were 38 focuses among 29 cases,including solitary lesions （n= 12） and multiple lesions （n= 3 ） in right lung, solitary lesions （n= 10） and multiple lesions （ n= 1 ） in left lung, and multiple lesions （ n= 3） in bilateral lungs. The first emergency CT findings included 5 types： （1） single cavities （n=3） and cavity lesions with air-fluid levels （n=10） ; 92） multiple cavity lesions with air-fluid levels （n=7） ; （3） single or multiple air cavities in patchy hemorrhage or wet lung （n=12） ; （4） simplex pulmonary hematomas （n= 3 ） ; （ 5） hematomas with bubbles inside （n= 3）. There were patchy, cloudy or halo-like ground glass opacity （GGO） around all of the focuses. CT findings in 16 cases followed up included： （1） in 1--3 days, the air cavity appeared air-fluid levels, the fluid in the cavity lesions with air-fluid levels increased, the cope of hemorrhage diminished and there became hematomas, with definite margins, the GGO around the lesions gradually absorbed; （2）in 4 days-3 weeks, 8 lesions be came hematomas, with definife margins（8/16）, 3 cavity with air-fluid levels lesions diminished, the air-fluid levels disappeared and became thick wall cavity（3/16 ）, 5 lesions didn＇t changed much（5/16）, the GGO around all the focuses became diminished or disappeared; （ 3） 3 weeks later, the cavity and the cavity with air-fluid levels diminished or disappeared, the cavity in hemorrhage entirely disappeared, pulmonary hemotomas diminished, small hematoma absorbed, leaving stripe-like shadows, 3 pulmonary hemotomas were not absorbed after half-year repeated CT examination,which appeared as masses. Conclusion cavity lesion,cavity with air-fluid levels, pulmona

关 键 词：肺 撕裂伤 体层摄影术 X线计算机 

分 类 号：R563[医药卫生—呼吸系统] R814.42[医药卫生—内科学]