成人正常肺吸气相呼气相HRCT表现  

Inspiratory and expiratory high-resolution CT findings in normal adults

作　　者：吴华伟[1] 许建荣[1] 程杰军[1] 沈加林[1] 华小兰[1] 

机构地区：[1]上海第二医科大学附属仁济医院放射科,上海200001

出　　处：《中国医学影像技术》2004年第3期419-422,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的　评价肺吸气相 呼气相HRCT的正常表现。方法　健康成人 46例 ,分别行吸气末及呼气末HRCT检查 ,分析气管形态、径线及面积的变化 ,肺衰减及肺面积的变化。结果　吸气相时气管为圆形或椭圆形 ,呼气相时气管大多数(63 % )为马蹄形 ;呼气相气管横断面积较吸气相平均减小 (2 3± 9) % ,前后径及横径平均分别减小 (2 2± 8) %、(15± 7) % ,气管面积缩小的百分比与前后径及横径缩小的百分比成正相关 (r=0 .63 3 ,0 .3 93 ,P <0 .0 1)。呼气相较吸气相肺衰减增加 ,以肺野后部及肺底水平增加为著 (P <0 .0 1) ;呼气相肺衰减梯度较吸气相明显 ,且以肺底为著 (P <0 .0 1) ;呼气相肺横断面积减小 ,平均减小 (2 1± 9) % ;隆突水平肺衰减增加与肺面积减小呈正比 (r=0 .70 2 ,P <0 .0 1)。呼气相时 2 8.3 % (13 /4 6)可见马赛克征。结论　肺吸气相 呼气相HRCT的正常表现不同。呼气相HRCT的气管形态大多为马蹄形 ,气管面积减小 ,前后径减小为主 ;呼气相时肺横断面积减小与肺衰减值增加呈正相关性 ,肺前后部衰减梯度明显 ,且以肺底为著。Objective To evaluate normal lung findings on inspiratory and expiratory HRCT. Methods Forty-six healthy adults underwent inspiratory and expiratory HRCT. The shape and cross-sectional area of trachea and lung were assessed, and the lung attenuation and the anteroposterior attenuation gradient were compared. Results The shape of normal trachea was round or elliptical on inspiration and mostly (63%) horseshoe-shaped at the end of a full expiration. The cross-sectional area of trachea decreased by an average of (23±9)% during expiration, and the anteroposterior and transverse diameters mean decreased (22±8)% and (15±7)%, respectively. The percentage decrease in cross-sectional area of trachea correlated well with the decrease in the anteroposterior and transverse diameters of the trachea from maximum inspiration to maximum expiration(r=0.633,0.393,P<0.01). Lung attenuation increased predominantly in the posterior part with the lung bases being the densest (P<0.01). The anteroposterior attenuation gradient became greater especially in the lung bases(P< 0.01). The mean cross-sectional area of lung decreased (21±9)% with expiration. The increase of lung attenuation correlated well with the decrease of the cross-sectional lung area(r=0.702, P< 0.01) at the carinal level. Thirteen volunteers (28.3%) showed mosaic perfusion pattern on expiratory scans. Conclusion The HRCT findings of the lung are different on inspiratory and expiratory scans. With expiration, the shape of trachea becomes horseshoe-shaped and the cross-sectional area decreases. There is a significant correlation between the decrease in cross-sectional lung area and the increase in lung attenuation. The anteroposterior attenuation gradient becomes greater, especially in the lung bases.

关 键 词：体层摄影术 X线计算机 肺 成人 

分 类 号：R322.35[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]