急性呼吸窘迫综合征及急性心源性肺水肿患者的胸部CT影像对比  

Comparison of chest CT images of patients with acute respiratory distress syndrome and acute cardiogenic pulmonary edema

作　　者：孙丽敏[1] 杜林娜[1] Sun Limin;Du Linna(Department of Computed Tomography,the Fourth People's Hospital of Hengshui City,Hengshui 053000,China)

机构地区：[1]河北省衡水市第四人民医院CT室

出　　处：《中国医师杂志》2019年第11期1676-1678,共3页Journal of Chinese Physician

摘　　要：目的对比急性呼吸窘迫综合征(ARDS)及急性心源性肺水肿(ACPE)患者的胸部CT影像。方法随机选取2016年8月至2018年8月本院收治的ARDS患者30例、ACPE患者30例,均接受胸部CT检查,统计分析两组患者的CT肺内磨玻璃密度影(GGO)分布情况、CT肺外结构改变情况。结果ARDS、ACPE患者的CT肺内GGO分布在上叶为主、中叶为主、下叶为主、弥漫分布比例[16.7%(5/30)、0、16.7%(5/30)、66.7%(20/30)vs 20.0%(6/30)、0、20.0%(6/30)、60.0%(18/30)]差异无统计学意义(P>0.05);ARDS患者的CT肺内GGO分布中心为主比例[13.3%(4/30)]显著低于ACPE患者[46.7%(14/30)](P<0.05),均匀分布比例[76.7%(23/30)]显著高于ACPE患者[46.7%(14/30)](P<0.05),但两组患者的CT肺内GGO分布外周为主比例[10.0%(3/30)、6.7%(2/30)]差异无统计学意义(P>0.05);ARDS、ACPE患者的CT肺内GGO分布右侧为主、左侧为主、双侧均匀比例[16.7%(5/30)、23.3%(7/30)、60.0%(18/30)vs 23.3%(7/30)、16.7%(5/30)、60.0%(18/30)]差异均无统计学意义(P>0.05)。ARDS患者的CT肺外结构小的边界不清透过度减低影比例[76.7%(23/30)]显著高于ACPE患者[26.7%(8/30)](P<0.05),支气管血束增厚、肺内血管影增粗、心影增大、心包积液比例[33.3%(10/30)、16.7%(5/30)、30.0%(9/30)、23.3%(7/30)]均显著低于ACPE患者[100.0%(30/30)、70.0%(21/30)、73.3%(22/30)、53.3%(16/30)](P<0.05)。结论ARDS及ACPE患者的胸部CT影像有差异,主要表现在小的边界不清透过度减低影、支气管血束增厚、肺内血管影增粗、心影增大、心包积液。Objective To compare the chest computed tomography( CT) images of patients with acute respiratory distress syndrome( ARDS) and acute cardiogenic pulmonary edema( ACPE). Methods30 cases of patients with ARDS and 30 cases of patients with ACPE from August 2016 to August 2018 were randomly selected. All patients underwent thoracic CT examination. The distributions of grinded glass density shadow( GGO) in the lungs and changes of extrapulmonary structure were statistically analyzed. Results The differences of distributions of GGO in the upper lobe,middle lobe,lower lobe and diffuse distribution between patients with ARDS and ACPE were not significant [16. 7%( 5/30),0,16. 7%( 5/30),66. 7%( 20/30) vs 20. 0%( 6/30),0,20. 0%( 6/30),60. 0%( 18/30),P > 0. 05]. The distributions of GGO in center lung [13. 3%( 4/30) ]was significantly lower than patients with ACPE [46. 7%( 14/30) ]( P <0. 05),while the uniform distribution rate [76. 7%( 23/30) ] was significantly higher than patients with ACPE [46. 7%( 14/30) ]( P < 0. 05),but distribution of GGO in the right side,left side,bilateral even in peripheral distribution of GGO in lung between patients with ARDS and ACPE were not significant[10. 0%( 3/30),6. 7%( 2/30),16. 7%( 5/30),23. 3%( 7/30),60. 0%( 18/30) vs 23. 3%( 7/30),16. 7%( 5/30) and 60. 0%( 18/30),P > 0. 05]. The small boundary opacity of patients with ARDS[76. 7%( 23/30) ]was significantly higher than patients with ACPE [26. 7%( 8/30) ]( P < 0. 05),while the bronchial blood bundle thickening,pulmonary vascular shadow thickening,cardiac shadow enlargement,pericardial effusion were significantly lower than patients with ACPE [33. 3%( 10/30),16. 7%( 5/30),30. 0%( 9/30),23. 3%( 7/30) vs 23. 3%( 7/30),100. 0%( 30/30),70. 0%( 21/30),73. 3%( 22/30),53. 3%( 16/30),P < 0. 05]. Conclusions The chest CT images of patients with ARDS and ACPE are different,mainly manifestated in small boundary opacity,bronchial blood bundle thickening,pulmonary vascular opacity,cardiac opacity,pericardial effusion.

关 键 词：呼吸窘迫综合征 成人 肺水肿 水肿 心源性 放射摄影术 胸部 

分 类 号：R54[医药卫生—心血管疾病]