创伤性湿肺的CT诊断

CT diagnosis of traumatic moist lung

目的分析创伤性湿肺的CT表现,并评价其对诊断与鉴别诊断的临床意义。方法对36例经临床证实为创伤性湿肺患者的胸部CT表现进行了回顾性分析。结果多数患者(31/36)的创伤性湿肺发生于单侧或双侧的中下肺野。本组患者的胸部CT表现可归纳为下述4种类型:a)弥漫实变型(17例)表现为单侧或双侧肺实质内散在斑点状或小片状稍高密度影;b)云雾型(14例)表现为单侧或双侧肺野呈磨玻璃样改变的稍高密度的云雾状影("面纱征");c)间质型(11例)表现为肺纹理增重或模糊的肺血管增粗影;d)节段实变型(10例)表现为呈节段分布的高密度大片状影。部分患者有两种或以上征象的并存。本组患者的并发症包括脑损伤(18例),肋骨骨折(11例),血胸与气胸(各9例)等。结论 CT能准确显示创伤性湿肺的部位、类型、范围及并发症,对诊断、鉴别诊断及疗效随访具有重要的临床意义。

Objective To analyze the CT findings of traumatic moist lung（TML） and to evaluate their clinical significance for the diagnosis and differential diagnosis.Methods Thirty-six patients with clinically proved TML underwent thoracic CT scans,subsequently,the CT findings of all the patients were retrospectively analyzed.Results Most TML lesions occurred in unilateral or bilateral middle and lower lung fields.The thoracic CT findings of TML in the group patients could be classified into following four patterns：a） diffuse consolidation pattern（n=17） appeared as scattered mottling or patchy shadows with slight hyperdense in unilateral or bilateral pulmonary parenchyma;b） cloud pattern（n=14） appeared as ground-glass like shadows with light hyperdense in unilateral or bilateral pulmonary fields,i.e.＂cloud sign＂;c）interstial pattern（n=11） appeared as hazy shadows of lung marking enhancing and pulmonary blood vessel thickening;d） segmentary consolidation pattern（n=10） appered as large patchy shadows with hyperdense in a lobur or a segmental distribution.Partial patients were found to have the coexistence of the two signs or over.The complications of the group patients included cerebral injury（n=18）,costal fracture（n=11）,hemothorax and pneumothorax（n=9 each） etc.Conclusion CT can accurately reveal the site,pattern,extent and complication of TML and therefore it has important clinical significance for the diagnosis,differential diagnosis and therapeutic follow-up.