静脉注射海洛因所致肺部感染性病变的螺旋CT表现

Spiral CT findings of pulmonary infection induced by intravenous injection of heroin

目的探讨静脉注射海洛因所致肺部感染性病变的螺旋CT表现,以提高其诊断水平。方法回顾性分析21例静脉注射海洛因继发肺部感染性病变患者的临床资料、螺旋CT表现。结果21例中均在首次螺旋CT平扫中发现病灶,表现为:(1)气囊,共13例(61.9%);(2)空洞,13例(61.9%);(3)实变,15例(71.4%);(4)胸膜改变,8例(38.1%),其中胸腔积液7例(33.3%);包裹性液气胸1例(0.48%)。单纯一种改变有3例(14.3%),两种及两种以上改变者18例(85.7%)。21例均有胸片对照,胸片有异常者20例(95.2%),病灶形态与CT类似,但螺旋CT图像上显示的病灶数和细微变化较胸片多;胸片未见明显异常者1例(4.8%),CT扫描发现有小气囊。结论螺旋CT扫描检出肺气囊、空洞、实变和胸膜改变4种征象,是静脉注射海洛因所致血源性肺部化脓性感染较特异性的表现,对其诊断和鉴别诊断有重要价值。

Objective To investigate spiral CT findings of pulmonary infection induced by intravenous injection of heroin. Methods The clinical data and spiral CT findings of 21 patients with pulmonary infection due to intravenous injection of heroin were analyzed retrospectively. Results Pulmonary lesions were detected in all these cases in the initial examination by spiral CT plain scan, including pneumatocele in 13 (61.9%), pulmonary cavity in 13 (61.9%), pulmonary consolidation in 15 (71.4%), and plural lesions in 8 cases (38.1%) of which 7 (33.3%) had plural effusion and 1 (0.48%) had encapsulated hydropneumothorax. Three cases had only one of the lesions and 18 had at least 2 of them. The CT images in each case were compared with X-ray film, and the latter displayed abnormalities in 20 cases (95.2%). X-ray failed to detect the lesions in 1 case (4.8%), in which pneumatocele was found in CT images. Conclusion The pulmonary lesions of pulmonary pneumato- cele, cavity, consolidation, and plural lesions are specific CT manifestations of hematogenous pulmonary suppurative infection induced by intravenous injection of heroin.