高原肺水肿的CT影像表现  

CT imaging findings of high altitude pulmonary edema

作　　者：索朗尼玛 卢海燕[1] 次旦旺久[1] 任翠 Suo langnima;LU Haiyan;Cidanwangjiu;REN Cui(Department of Radiology,the People’s Hospital of Tibet Autonomous Region,Lhasa 850000,China;Department of Radiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]西藏自治区人民医院放射科,西藏拉萨850000 [2]北京大学第三医院放射科,北京100191

出　　处：《实用放射学杂志》2023年第3期388-391,399,共5页Journal of Practical Radiology

摘　　要：目的探讨高原肺水肿(HAPE)的CT影像表现。方法回顾性收集100例HAPE患者的临床及影像学资料,分析HAPE的分布、形态、密度、是否合并胸腔积液及心脏增大等其他影像学特征。结果100例HAPE患者,平均进藏时间为6.2 d,男83例,女17例,性别比例有显著差异(P<0.0001)。79例HAPE表现为双肺多发磨玻璃密度影伴小结节及实变影,显著多于其他类型病变的总和(P<0.0001)。97例患者表现为双肺病变不对称,右肺重于左肺的患者81例,显著多于左肺重于右肺及双肺病变基本对称的患者(P<0.0001)。其他胸部CT征象包括小叶间隔增厚、空气支气管征、代偿性肺气肿及树芽征。仅4例患者合并右侧胸腔积液,所有患者均无心脏增大。结论HAPE患者的胸部CT表现主要为双肺多发不对称的磨玻璃密度影伴小结节及实变影。Objective To investigate the CT imaging findings of high altitude pulmonary edema(HAPE).Methods The clinical and imaging data of 100 patients with HAPE were retrospectively enrolled,and the HAPE imaging characteristics,including the distribution,morphology,density,with or without pleural effusion,cardiac enlargement were analyzed.Results Among the 100 HAPE patients,83 were male and 17 were female,with an average time of entering Tibet 6.2 days.There was a significant difference in gender ratio(P<0.0001).79 cases of HAPE showed multiple ground glass density shadows with small nodule shadows and consolidation in both lungs,which were significantly more than the sum of other types of lesions(P<0.0001).97 patients showed asymmetry of bilateral lung lesions.A total of 81 patients with right lung lesions more severe than that of the left lung,which were significantly more than those with left lung lesions severe than the right lung and patients with basically symmetrical bilateral lung lesions(P<0.0001).Other chest CT signs included interlobular septal thickening,air bronchial sign,compensatory emphysema and tree bud sign.Only 4 cases were complicated with right pleural effusion,and all patients had no cardiac enlargement.Conclusion The mainly chest CT findings of HAPE patients are multiple asymmetric ground glass density shadows with small nodule shadows and consolidation in both lungs.

关 键 词：高原肺水肿 影像表现 计算机体层成像 

分 类 号：R541.33[医药卫生—心血管疾病] R814.42[医药卫生—内科学]