创伤性湿肺的影像表现和临床动态观察  

CT Features and Dynamic Observation of Traumatic Wet Lung

作　　者：吴茂铸[1] 倪淑红[2] 应琦[1] 赵年家[1] 蔡卫东[1] 王健[1] 周智建[1] 

机构地区：[1]浙江省台州医院路桥院区放射科,318050 [2]浙江省台州医院路桥院区门诊部,318050

出　　处：《医学研究杂志》2012年第11期137-141,共5页Journal of Medical Research

摘　　要：目的探讨创伤性湿肺(traumatic wet lung,TWL)的影像表现并动态观察其演变过程。方法回顾性分析86例闭合性胸部外伤TWL病例的临床及影像学资料。全部病例于伤后0.5～6.0h行急诊多排螺旋CT检查并于首次CT检查后1～3天、4～21天和21天后复查,31例同期行X线胸片检查。结果 X线表现:肺内片状密度增高影14例、肺纹理增强6例,阴性11例(35.5%)。CT表现:(1)病变分布:两肺58例(67.4%);单侧肺28例(32.6%),其中右肺15例,左肺13例。累及单个肺叶16例(18.6%),2个及2个以上肺叶70例(81.4%),共涉及肺叶181叶。(2)病变类型:间质型17例(19.7%),云雾型30例(34.9%),弥漫实变型25例(29.1%),叶段实变型14例(16.3%)。(3)CT复查表现:1～3天内病变进展17例(19.8%),包括间质型6例、云雾型7例、弥漫实变型4例。间质型、云雾型、弥漫实变型、叶段实变型完全吸收17例、28例、21例和9例,11例基本吸收遗留少许索条状影像;CT显示各型TWL完全或基本吸收时间范围分别为1～5天、3～10天、5～14天、7～34天,中位时间分别为2.0、5.0、8.0、18.0天,其吸收时间的差异有统计学意义(t=4.62,6.16,8.38,P均<0.001)。结论 CT是早期发现、诊断、动态监测创伤性湿肺的最佳影像学检查方法并有助于临床病情、病程和预后的判断。Objective To explore imaging appearances and dynamic imaging changes in clinically diagnosed traumatic wet lung. Methods Imaging data and clinical data of 86 patients with traumatic wet lung were retrospectively analyzed. All patients underwent CT within 0.5 -6. Oh after injury and 31 patients underwent chest radiographs as well. Rechecked after initial CT scan were performed at 1 - 3day,4 -21days and 21days later. Results Chest radiography findings： focal patchy opacity in 14 cases, thickness and blurring of the shadow of pulmonary blood vessels in 6 cases, no findings in 11 cases （ 35.5% ）. CT findings ： （ 1 ） Location ： bilateral pulmonary involve- ment was revealed in 58cases（67.4% ） ; unilateral involvement in 28 cases（32.6% ） , of which right lung were in 15 cases, and left in 13. The lesion was confined within one lobe in 16 cases（ 18. 6% ） , two lobes and more lobes in 70 （ 81.4% ） ; totally 181 lobes were in- volved in all patients. （2）Lesions type： The interstitial type were found in 17 cases（ 19. 7% ）, the cloudy- mist type in 30 cases （34.9%） , the disseminated consolidation type in 25 cases（29.1% ） , the segmental consolidation type in 14 cases（ 16.3% ）. （3）The performance of CT dynamic observation： The TWL lesions progressed in 17 cases（ 19.8% ） ,of which the interstitial type were in 6 cases, the cloudy - mist type in 7 and the disseminated consolidation type in 4. TWL Lesions presented with absorption and dissipation in 17 ca- ses of the interstitial type, in 28 of the cloudy - mist type, in 21 of the disseminated consolidation type, in 9 of the segmental consolidation type, respectively,and irregular lines were left in 11 cases. The absorption and dissipation time of the type of interstitial, cloudy - mist, disseminated consolidation and segmental consolidation were 1 - 5days, 3 - 10days,5 - 14days,7 - 34days, and the average time were 2.0days, 5.0days, 8.0days, 18.0days, respectively. There were significant difference of the absorptio

关 键 词：胸部外伤 创伤性湿肺 体层摄影术 X线计算机 评价研究 

分 类 号：R655.3[医药卫生—外科学]