百草枯中毒肺损害的X线与CT表现(附14例报告)  

The lung of paraquat poisoning: radiographic and CT findings (a report of 14 cases)

作　　者：韩东明[1] 王清华[1] 孙建明[1] 窦文广[1] 孙凤霞[1] 李玉侠[1] 李长松[1] 

机构地区：[1]新乡医学院附属第一医院放射科,河南453100

出　　处：《放射学实践》2003年第11期811-813,共3页Radiologic Practice

摘　　要：目的 :提高对百草枯中毒肺损害的X线与CT表现的认识。方法 :14例百草枯中毒患者摄胸片 ,并行CT扫描 ,随访 9例 (胸片 4例 ,CT/HRCT 5例 )。结果 :中毒后第 1周 :两肺纹理增多、模糊 10例 ,伴两肺散在磨玻璃影 3例 ,两中下肺小斑片状实变 2例。第 2～ 3周 :显示磨玻璃影 5例 ,实变 3例 ,肺不张 1例 ,其中伴有两侧少量胸腔积液 2例、牵引性细支气管扩张 1例。第 4～ 5周 :肺实变中含有牵引性细支气管扩张 2例 ,局灶性蜂窝 1例。第 7周 :1例CT(含HRCT)显示磨玻璃影与实变影较前缩小 ,肺纤维化改变明显 ,并有心脏轻度增大、纵隔气肿等。结论 :胸片、CT尤其是HRCT能很好显示百草枯中毒肺纤维化的病理演变过程 ,有助于判断其临床阶段 。Objective:To enhance the understanding of paraquat lung on chest radiography and CT.Methods:The chest radiographic and CT findings of 14 cases of paraquat lung were reported.9 cases were followed up with chest radiography in 4 and CT scans in 5.Results:The chest radiography and CT revealed exaggerated and indistinct lung markings in 10 cases,three of them accompanied ground glass opacity and two of them accompanied patchy consolidation of bilateral mid lower lung field in the first week.Ground glass opacity was present in 5,consolidation in 3,atelectasis in 1 at the 2～3rd week,and of which two accompanied bilateral pleural effusion and one accompanied traction bronchiectasis.Consolidation containing traction bronchiectasis in 2 cases and local honeycomb in 1 was found at the 4～5th week.At the 5～7th week,CT scans showed decrease of ground glass opacity and consolidation,and increased interstitial fibrosis in one case,who showed additional cardiac enlargement and mediastinal emphysema.Conclusion:Chest radiography and CT,especially HRCT can distinctly show the pathologic course of pulmonary fibrosis in paraquat lung,which is helpful for assessment of its clinical stage and treatment planning.

关 键 词：百草枯中毒 肺功能 影像学表现 肺纤维化 支气管扩张 

分 类 号：R816.4[医药卫生—放射医学]