百草枯中毒的胸部CT表现

CT findings on the pulmonary alteration of paraguat poisoning

目的 分析探讨百草枯中毒的胸部 CT表现特征。方法 回顾性观察分析 18例百草枯中毒病人的胸部CT影像学表现 (其中应用 CT规律观察 12例 ,6例只有一周内胸部 CT影像资料 ,8例次行 HRCT)。结合临床 ,总结肺、纵隔及胸壁 CT的影像学特征。结果 18例中 12例存活 3周以上的患者 ,中毒早期 (2天以内 ) ,其中 6例肺出现通气过度及局限性浅淡毛玻璃密度 ,6例胸部无明显改变。中期 (3～ 14天 ) ,12例均出现胸部 CT影像的明显变化 ,以广泛毛玻璃密度、肺实性变、渗出性病变、肺间质改变为主 (分别占 91.7%、66.7%、91.7%、10 0 % ) ,出现胸腔积液 7例 ,心包积液 4例。中后期 (14天以上 )变化不显著 ,表现以肺渗出、实变、肺纤维化为主。另 6例中毒程度严重者 ,中早期即以渗出性病变及肺实变为主。结论 百草枯中毒的胸部 CT表现具有一定的特征性 。

Objective TO analyze and discuss the CT findings Of paraguat induced pulmonary damage.Methods The chest CT appearances in 18 patients with paraquat poisoning were reviewed retrospectively.Result CT materials in 12 cases,CT materials of one week in 6 cases,and HRCT in 8 cases.The characteristics on CT were summarized about lung,mediastinum and chest wall.Results 12 patients survived over 3 weeks.In the early period within 2 days,in 6 of them the predominant findings were hyperventilation,and local glass density,while the other 6 cases showed normal.In late period fron 3 to 14 days,All the 12case showed obvious abnormalities on CT,particular in extensive glass density,exudation and interstitial changes and pleural effusion in 7 cases,pericardial effusion in 4 cases.The CT appearances were exudation,consolidation and fibrosis after 14 days.The exudation and consolidation changes could be seen early in 6 patients with severe poisoning.Conclusion CT scan in showing paraguat poisoning is unrivaled,it has a important significance in diagnosis,judgment Of therapy effect,prognosis and follow up.