肺撕裂伤的256层螺旋CT诊断分析  

Diagnostic Efficacy of 256-Slice Spiral CT for Lung Laceration

作　　者：赵鹤亮[1] 项昆[2] 赵新斌[1] 张惠英[1] 

机构地区：[1]河北联合大学附属医院CT室 [2]唐山市协和医院CT/MR室,河北唐山063000

出　　处：《南昌大学学报（医学版）》2014年第12期35-38,88,共5页Journal of Nanchang University：Medical Sciences

基　　金：唐山市科技局科技指令性计划(13130273z);2012年河北联合大学青年科学基金(z201229)

摘　　要：目的总结肺撕裂伤的影像学特征及损伤机制、演变规律。方法利用256层螺旋CT对32例（48个病灶）肺撕裂伤患者的CT图像进行回顾性分析。结果圆形/类圆形组病灶位于胸膜下23个（62.2%）,非胸膜下14个（37.8%）;不规则形组病灶位于胸膜下10个（90.9%）,非胸膜下1个（9.1%）。不规则形组病灶位于胸膜下的发生率高于圆形/类圆形组（χ^2=4.016,P〈0.05）。按照肺撕裂伤的演变形式分为3组,即气囊组（20个）、气液囊组（12个）及血肿组（16个）。其中气囊组病灶位于胸膜下14个（70.0%）,非胸膜下6个;气液囊组病灶位于胸膜下10个（83.3%）,非胸膜下2个;血肿组病灶位于胸膜下8个（50.0%）,非胸膜下8个,3组病灶的分布情况比较差异无统计学意义（χ^2=1.801,P〉0.05）。当周围肺组织实变进一步加重时,气囊或气液囊的最大径较前变小;当周围肺组织实变明显吸收好转后,原来变小的气囊或气液囊又恢复到未发生实变前大小。所有病灶经过保守治疗后痊愈,在复查过程中病灶的最大径没有继续扩大,并且在15～90 d完全吸收。结论肺撕裂伤的3个演变形式为气囊、气液囊、血肿;256层螺旋CT及其后处理技术可以较好地观察肺撕裂伤的位置及形态分布等特征,对于及时正确诊断很有价值。Objective To summarize the imaging characteristics,damage mechanism and evolution of lung laceration. Methods Image data of 32 patients with lung laceration（ 48 lesions） who underwent256-slice spiral CT were retrospectively analyzed. Results In circular / circular-like group,23 lesions（ 62. 2%） were subpleural and 14 lesions（ 37. 8%） were non-subpleural. In irregular group,10 lesions（ 90. 9%） were subpleural and 1 lesion（ 9. 1%） was non-subpleural. The incidence of subpleural lesions in irregular group was significantly higher than that in circular / circular-like group（ χ2= 4. 016,P〈0.05）. According to the evolution of lung laceration,these lesions were divided into three groups： air cyst group（ n = 20）,air-liquid cyst group（ n = 12） and hematoma group（ n = 16）. In air cyst group,14 lesions（ 70. 0%） were subpleural and 6 lesions were non-subpleural. In air-liquid cyst group,10 lesions（ 83.3%） were subpleural and 2 lesions were non-subpleural. In hematoma group,8 lesions（ 50. 0%） were subpleural and 8 lesions were non-subpleural. There were no significant differences in the distribution of lesions among the three groups（ χ2= 1. 801,P〈0. 05）. The largest diameter of air cysts or air-liquid cysts decreased when parenchymal lung lesions were further aggravated. However,the air cysts or air-liquid cysts returned to the previous size after parenchymal lung lesions were obviously improved. All lesions healed after conservative treatment. In addition,the largest diameter of lesions did not increase at reexamination and complete absorption was observed between 15 and 90 days after treatment. Conclusion The air cysts,air-liquid cysts or hematomas can develop as a result of lung laceration. The 256-slice spiral CT and post-processing technology can be used to observe the location and distribution of lung laceration.Therefore,256-slice spiral CT is of great value in the diagnosis of lung laceration.

关 键 词：体层摄影术 X线计算机 肺撕裂伤 诊断 

分 类 号：R445.3[医药卫生—影像医学与核医学] R655[医药卫生—诊断学]