80例放射性肺炎的CT表现及分析

CT finding of radiation pneumonitis in 80 cases and analysis

目的为提高对早期放射性肺炎的诊断。方法回顾性观察分析经治疗和临床随访证实为放射性肺炎的80例患者(男性52例,女性28例,年龄最小35岁,最大76岁)的CT影像资料。结果放射性肺炎急性期表现为边界清晰或不清晰的实变影,内可见支气管充气征。慢性期表现为边界清晰的条索状阴影并可交织成网状,伴有肺气肿及横膈升高、纵隔移位以及胸廓塌陷畸形等。结论放射性肺炎病变绝大多数限于放射治疗野内,病变区及外周肺血管缩小或减少,急性期为渗出病灶为主,慢性期为纤维病灶为主,发生的严重程度与肺受照射面积和总剂量有关。应与肺癌放疗后复发、获得性肺炎和肺不张鉴别。

Objective To improve early diagnosis of radiation pneumonitis. Methods CT imaging data of 80 patients（52 male and 28 famale, age ranging from 35 to 76）were observed and analysed retrospectively. Results The CT finding of radiation pneumonitis showed which had a clear or blurry boundary and Air bronchogram during the acute period, and it showed fibrotie focus with a clear boundary during the chronic period with emphysema and rise the diaphram, mediastinal shift and theracie collapse, and other deformities. Conclusion The pathological area mostly locates within the radiotheraphy field,and the damage depends on the irradiation area and total absorbed dose. CT finding shows transudatory focus mostly appear in the acute period, and fibrotic focus mostly appear in the chronic period. Shrink and decrease of the pathological area veins and the exterior lung veins can be observed. It is important to distinguish radiation pneumonitis from recrudescence of lung cancer after radiotherapy, pneumonia and atelectasis.