南昌大学学报(医学版)
南昌大學學報(醫學版)
남창대학학보(의학판)
ACTA ACADEMIAE MEDICINAE JIANGXI
2014年
12期
35-38,88
,共5页
赵鹤亮%项昆%赵新斌%张惠英
趙鶴亮%項昆%趙新斌%張惠英
조학량%항곤%조신빈%장혜영
体层摄影术%X 线计算机%肺撕裂伤%诊断
體層攝影術%X 線計算機%肺撕裂傷%診斷
체층섭영술%X 선계산궤%폐시렬상%진단
computed tomography%X-ray computed%lung laceration%diagnosis
目的:总结肺撕裂伤的影像学特征及损伤机制、演变规律。方法利用256层螺旋 CT 对32例(48个病灶)肺撕裂伤患者的 CT 图像进行回顾性分析。结果圆形/类圆形组病灶位于胸膜下23个(62.2%),非胸膜下14个(37.8%);不规则形组病灶位于胸膜下10个(90.9%),非胸膜下1个(9.1%)。不规则形组病灶位于胸膜下的发生率高于圆形/类圆形组(χ2=4.016,P <0.05)。按照肺撕裂伤的演变形式分为3组,即气囊组(20个)、气液囊组(12个)及血肿组(16个)。其中气囊组病灶位于胸膜下14个(70.0%),非胸膜下6个;气液囊组病灶位于胸膜下10个(83.3%),非胸膜下2个;血肿组病灶位于胸膜下8个(50.0%),非胸膜下8个,3组病灶的分布情况比较差异无统计学意义(χ2=1.801,P >0.05)。当周围肺组织实变进一步加重时,气囊或气液囊的最大径较前变小;当周围肺组织实变明显吸收好转后,原来变小的气囊或气液囊又恢复到未发生实变前大小。所有病灶经过保守治疗后痊愈,在复查过程中病灶的最大径没有继续扩大,并且在15~90 d 完全吸收。结论肺撕裂伤的3个演变形式为气囊、气液囊、血肿;256层螺旋 CT 及其后处理技术可以较好地观察肺撕裂伤的位置及形态分布等特征,对于及时正确诊断很有价值。
目的:總結肺撕裂傷的影像學特徵及損傷機製、縯變規律。方法利用256層螺鏇 CT 對32例(48箇病竈)肺撕裂傷患者的 CT 圖像進行迴顧性分析。結果圓形/類圓形組病竈位于胸膜下23箇(62.2%),非胸膜下14箇(37.8%);不規則形組病竈位于胸膜下10箇(90.9%),非胸膜下1箇(9.1%)。不規則形組病竈位于胸膜下的髮生率高于圓形/類圓形組(χ2=4.016,P <0.05)。按照肺撕裂傷的縯變形式分為3組,即氣囊組(20箇)、氣液囊組(12箇)及血腫組(16箇)。其中氣囊組病竈位于胸膜下14箇(70.0%),非胸膜下6箇;氣液囊組病竈位于胸膜下10箇(83.3%),非胸膜下2箇;血腫組病竈位于胸膜下8箇(50.0%),非胸膜下8箇,3組病竈的分佈情況比較差異無統計學意義(χ2=1.801,P >0.05)。噹週圍肺組織實變進一步加重時,氣囊或氣液囊的最大徑較前變小;噹週圍肺組織實變明顯吸收好轉後,原來變小的氣囊或氣液囊又恢複到未髮生實變前大小。所有病竈經過保守治療後痊愈,在複查過程中病竈的最大徑沒有繼續擴大,併且在15~90 d 完全吸收。結論肺撕裂傷的3箇縯變形式為氣囊、氣液囊、血腫;256層螺鏇 CT 及其後處理技術可以較好地觀察肺撕裂傷的位置及形態分佈等特徵,對于及時正確診斷很有價值。
목적:총결폐시렬상적영상학특정급손상궤제、연변규률。방법이용256층라선 CT 대32례(48개병조)폐시렬상환자적 CT 도상진행회고성분석。결과원형/류원형조병조위우흉막하23개(62.2%),비흉막하14개(37.8%);불규칙형조병조위우흉막하10개(90.9%),비흉막하1개(9.1%)。불규칙형조병조위우흉막하적발생솔고우원형/류원형조(χ2=4.016,P <0.05)。안조폐시렬상적연변형식분위3조,즉기낭조(20개)、기액낭조(12개)급혈종조(16개)。기중기낭조병조위우흉막하14개(70.0%),비흉막하6개;기액낭조병조위우흉막하10개(83.3%),비흉막하2개;혈종조병조위우흉막하8개(50.0%),비흉막하8개,3조병조적분포정황비교차이무통계학의의(χ2=1.801,P >0.05)。당주위폐조직실변진일보가중시,기낭혹기액낭적최대경교전변소;당주위폐조직실변명현흡수호전후,원래변소적기낭혹기액낭우회복도미발생실변전대소。소유병조경과보수치료후전유,재복사과정중병조적최대경몰유계속확대,병차재15~90 d 완전흡수。결론폐시렬상적3개연변형식위기낭、기액낭、혈종;256층라선 CT 급기후처리기술가이교호지관찰폐시렬상적위치급형태분포등특정,대우급시정학진단흔유개치。
Objective To summarize the imaging characteristics,damage mechanism and evolu-tion of lung laceration.Methods Image data of 32 patients with lung laceration(48 lesions)who underwent 256-slice spiral CT were retrospectively analyzed.Results In circular/circular-like group,23 lesions(62.2%)were subpleural and 14 lesions(37.8%)were non-subpleural.In irreg-ular group,10 lesions(90.9%)were subpleural and 1 lesion(9.1%)was non-subpleural.The inci-dence of subpleural lesions in irregular group was significantly higher than that in circular/circu-lar-like group(χ2 =4.016,P <0.05).According to the evolution of lung laceration,these lesions were divided into three groups:air cyst group(n=20),air-liquid cyst group(n=12)and hematoma group(n=16).In air cyst group,14 lesions(70.0%)were subpleural and 6 lesions were non-sub-pleural.In air-liquid cyst group,10 lesions(83.3%)were subpleural and 2 lesions were non-sub-pleural.In hematoma group,8 lesions(50.0%)were subpleural and 8 lesions were non-subpleu-ral.There were no significant differences in the distribution of lesions among the three groups (χ2 =1.801,P >0.05).The largest diameter of air cysts or air-liquid cysts decreased when paren-chymal lung lesions were further aggravated.However,the air cysts or air-liquid cysts returned to the previous size after parenchymal lung lesions were obviously improved.All lesions healed after conservative treatment.In addition,the largest diameter of lesions did not increase at reexamina-tion and complete absorption was observed between 15 and 90 days after treatment.Conclusion The air cysts,air-liquid cysts or hematomas can develop as a result of lung laceration.The 256-slice spiral CT and post-processing technology can be used to observe the location and distribution of lung laceration.Therefore,256-slice spiral CT is of great value in the diagnosis of lung lacera-tion.