急性肺撕裂伤的CT表现及其诊断价值

CT Manifestations and Diagnosis Value of Acute Lung Lacerated Wound

目的:探讨急性肺撕裂伤的CT表现及其诊断价值。材料与方法:20例急性肺撕裂伤患者,均于伤后1-10小时行CT检查,其中17例在10小时内行X线检查。结果:20例急性肺撕裂伤中,17例发生在中下肺叶,仅3例发生在两肺上叶,绝大多数位于肺的边缘部位及脊柱旁。单发4例,单侧多发14例,双侧多发2例。其中肺气囊肿18个,多为薄壁;肺气液囊肿43个,壁厚薄不均匀,囊内积液多为少量,内壁光滑,多个小囊聚集5例,大囊周边多个小囊聚集3例;楔形含气裂隙3例,长80-95mm,裂口外侧达肺表面胸膜下,内侧达肺野内带脊柱旁;肺内血肿3个,呈类圆形高密度影。合并肺挫伤17例,肋骨骨折12例,液气胸8例,气胸3例,头胸腹部等多发伤8例。结论:肺气囊肿、肺气液囊肿是急性肺撕裂伤特征性CT表现,肺楔形含气裂隙是本病特有的征像,CT是明确急性肺撕裂伤诊断及其严重程度的最敏感、最特异性的影像检查方法。

Purpose：To explore the CT manifestationgs and diagnosis value in acute lung lacerated wound.Materials and Methods：Twenty patients of acute lung lacerated wound were examined by CT within 1-10h after injury,among seventeen patients were examined by X-ray within 10h.Results：Of twenty patients,acute lung lacerated wound involved the suffer-lower lung lobe in 17 cases and the upper lung lobe in 3 cases,among which 4 cases involved the lung lobe with 1 lesion,14 cases in the singular side lung with multilesion,2 cases in the both sides lung with multilesion.CT imaging findings included lung air-filled cysts with thin walls in 18 cases,fluid and air-filled cysts with irregular walls in 43 cases,wedged and air-filled cranny with breachs of 80-95mm in 3 cases,hematomas with roundness in 3 cases.The cases simultaneously had lung contuse in 17cases,rib bone fractures in 12 cases,pneumothorax in 8 cases,hydropneumothorax in 3 cases,craniocerebral or abdomen trauma in 8 cases.Conclusion：Lung air-filled cysts or fluid and air-filled cysts is the characteristic CT imaging finding of acute lung lacerated wound,wedged and air-filled cranny is the specialties imaging,CT is the best susceptible and the best special imaging wise of clear diagnosis and trauma grade about acute lung lacerated wound.