CAJ | 학술논문

目的分析心源性肺水肿患者的肺部X线与CT影像学表现,从而提高心源性肺水肿患者的诊断准确率.方法自2010年1月至2013年1月共收治100例心源性肺水肿患者,均于发病24h内分别对患者行肺部X线与CT检查,对比分析其影像学表现.结果急性心源性肺水肿X线表现以肺泡性肺水肿为主,X线表现与肺部CT影像学表现相似,为腺泡结节、斑片状及大片融合影,有时可见空气支气管像,病变边缘模糊.病变进展时双肺出现广泛的密度均匀实变阴影,典型者出现“蝶翼征”.病变征象检出率,二者比较差异无统计学意义.慢性心源性肺水肿多表现为间质性肺水肿,肺部X线与CT影像学表现以肺血重新分布,肺野透光度降低,肺纹理增多、增重,小叶间隔线增厚如胸膜下线、克氏线出现以及肺实质磨玻璃样变等间质性肺水肿改变为主,病变征象检查率、肺部CT征象分辨率较高,二者比较差异有统计学意义(P＜0.05).结论急性心源性肺水肿的肺部X线与CT征象表现相似,临床诊断率相当,而慢性心源性肺水肿的肺部CT检查能提供更多的诊断信息,提高临床诊断率.
목적 분석심원성폐수종환자적폐부X선여CT영상학표현,종이제고심원성폐수종환자적진단준학솔.방법 자2010년1월지2013년1월공수치100례심원성폐수종환자,균우발병24h내분별대환자행폐부X선여CT검사,대비분석기영상학표현.결과 급성심원성폐수종X선표현이폐포성폐수종위주,X선표현여폐부CT영상학표현상사,위선포결절、반편상급대편융합영,유시가견공기지기관상,병변변연모호.병변진전시쌍폐출현엄범적밀도균균실변음영,전형자출현“접익정”.병변정상검출솔,이자비교차이무통계학의의.만성심원성폐수종다표현위간질성폐수종,폐부X선여CT영상학표현이폐혈중신분포,폐야투광도강저,폐문리증다、증중,소협간격선증후여흉막하선、극씨선출현이급폐실질마파리양변등간질성폐수종개변위주,병변정상검사솔、폐부CT정상분변솔교고,이자비교차이유통계학의의(P＜0.05).결론 급성심원성폐수종적폐부X선여CT정상표현상사,림상진단솔상당,이만성심원성폐수종적폐부CT검사능제공경다적진단신식,제고림상진단솔.
Objective To analyze the lung X-ray and CT imaging features of patients with cardiogenic pulmonary edema,thereby enhancing the diagnostic accuracy in patients with the cardiogenic pulmonary edema.Methods From January 2010 to January 2013,100 patients with cardiogenic pulmonary edema were selected,all patients underwent the lung X-ray and CT examinations within 24 hours of onset,and then comparative analysis of the imaging manifestations was made.Results Acute cardiogenic pulmonary edema X-ray showed pulmonary edema with alveolar master,X-ray and CT imaging had some similar performances and manifested as acinar nodules,patchy and large fusion shadow,sometimes visible as air bronchial lesion,edge blurred.There was extensive consolidation of uniform density shadow when lung lesions progressed,with "Butterfly levy" as the typical sign.The rate of lesion detection was similar,the difference was not statistically significant.Chronic cardiogenic pulmonary edema showed more interstitial pulmonary edema,and chest X-ray and CT imaging showed pulmonary blood redistribution,lung transmittance decreased,increased lung markings,weight gain,such as pleural thickening of interlobular septal lines with increased lung markings,thickened septal lines,numerous Kerley lines,peribronchial cuffing and lung parenchyma appeared GGO and other interstitial changes in the main pulmonary edema.The lesion signs inspection rate of pulmonary high resolution CT findings was higher than that of X-ray,the difference was statistically significant.Conclusions For acute cardiogenic pulmonary edema,chest X-ray and CT findings are similar and the clinical diagnosis rate is the same,and chronic cardiogenic pulmonary edema,pulmonary CT examination can provide more diagnostic information and improve the clinical diagnosis rate.