肺脂肪栓塞综合征的X线及螺旋CT诊断

Pulmonary Fat Embolism Syndrome:X-ray and CT Imaging Characteristics

目的:探讨肺脂肪栓塞综合征的X线及CT特点。方法:回顾性分析8例被诊断为肺脂肪栓塞患者的影像资料,由两位放射科医师对患者的胸部X线片及多层螺旋CT图像进行评价。结果:行X线片扫描5例表现为双肺弥漫性分布的片状密度增高影,2例表现为双肺中下野分布为主的片状阴影,1例仅表现为肺纹理增强。行CT检查5例表现为磨玻璃样改变(3例弥漫性分布、1例呈"地图样"片状分布、1例合并肺小叶间膈增厚呈现网状阴影),3例表现为多发实变影或结节影,2例合并有双侧胸腔积液。结论:X线平片仍是诊断肺脂肪栓塞比较可靠的影像学检查方法,螺旋CT能够提供更多特征性的影像信息。

Objective： To investigate radiographic and computed tomography features of pulmonary fat embolism syndrome （FES）. Method： A retrospective review was performed on the data of 8 cases FES proved by clinical diagnosis. The chest radiographs and CT studies were assessed by two radiologists. Results： On chest radiographs, bilateral diffuse distributed pulmonary shadows were seen in 5 cases, a middle or lower predominance in 2 cases. Increased pulmonary markings were seen in 1 case. On CT scans, 5 cases showed ground-glass opacities, which had a diffuse distribution in 3 cases, patchy distribution resulting in a geographic appearance in 1 cases, the other one with intralobular septal thickening. Multi-focal areas of consolidation or nodules were seen in 2 patients. Bilateral pleural effusion was seen in 2 patients. Conclusion： Radiography is still the reliable modality in diagnosing FSE and MSCT can provide much more characteristic information.