肺撕裂伤的CT诊断及分型  

CT Diagnosis and Classification of Pulmonary Laceration

作　　者：刘成磊[1] 孙志先[1] 刘婕[1] 孙毅[1] 耿磊[1] 张毅[1] 

机构地区：[1]江苏省连云港市第二人民医院放射科,222023

出　　处：《临床放射学杂志》2015年第5期725-728,共4页Journal of Clinical Radiology

基　　金：连云港市卫生局科研课题计划项目(编号:局1318)

摘　　要：目的分析肺撕裂伤的CT征象并探讨其分型。方法回顾性分析28例肺撕裂伤的CT表现。结果28例患者共累计47个肺叶(63个病灶),其中右肺上叶10个,右肺中叶7个,右肺下叶18个,左肺上叶8个,左肺下叶20个,63个病灶中34个位于肺表面或胸膜下,20个位于脊柱旁,9个病灶位于肺深部。CT表现为肺气囊14个、肺气液囊17个、胸膜下气泡影22个,肺血肿10个,肺撕裂伤周围均合并不同程度的肺挫伤。CT分型为I型5例,Ⅱ型12例;Ⅲ型8例,Ⅰ型+Ⅱ型同时存在3例。25例患者伴有肋骨骨折,13例患者合并血气胸,6例患者合并皮下气肿,2例患者合并纵隔气肿,1例患者合并血管损伤。结论 CT检查可早期发现、诊断和动态观察肺撕裂伤,气液囊及胸膜下气泡影为其特征性表现。Objective To analyze CT findings of pulmonary laceration and to discuss its classification. Methods CT findings of twenty-eight patients with pulmonary laceration were retrospectively analyzed. Results In the 28 patients, the pulmonary laceration involoved 47 lung lobes （63 lesions in total）, including the right upper lobe （n = 10）, right middle lobe （n =7）, right lower lobe （n = 18）, left upper lobe （n =8） and left lower lobe （n =20）. The locations of the 63 le- sions of laceration included lung surface or sub-pleural region （ n = 34） , paravertebral area （ n = 20） and deep site of lung （ n = 9 ）. CT findings were pneumatocele （ n = 14 ）, pulmonary liquid-air cavity （ n = 14）, sub-pleural gas-bubble shadow （n = 22） and intrapulmonary hematoma （n = 10）. Various degrees of lung contusion around the pulmonary laceration could be observed in all patients. The lung lacerations were classified in type ] （n =5）, type 11 （n = 12） and type Ill （n =8） ; and three patients showed both type I and type HI lacerations. Rib fracture was detected in 25 patients, hemopneumothorax in 13 patients, subcutaneous emphysema in 6 patients, pneumomediastinum in 2 patients and vascular injury in one patient. Conclusion CT examination can early detect and diagnose the pulmonary laceration, it can also dynamically observe the changes of pulmonary laceration. The pulmonary liquid-air cavity and sub-pleural gas-bubble shadow are the charaeteristic signs of pulmonary laceration.

关 键 词：肺 撕裂伤 体层摄影术 X线计算机 

分 类 号：R655.3[医药卫生—外科学]