影像学与临床表现密切结合诊断肺梗塞

Pulmonary infarction integrated diagnosis by imageology and clinical manifestations

目的 提高肺梗塞的诊断与鉴别能力。方法 2 0例肺梗塞的患者 ,其主要症状有突发胸闷、气短、呼吸困难、剧烈胸痛、咳血、低烧等。患者均拍 1次以上正侧全胸片 ,14例行胸部CT扫描 ,4例行SPECT检查 ,9例做心脏超声心动图。结果 发生于上叶的梗塞灶 3例 ,中叶 5例 ,下叶 13例 ,其中 6例为多叶分布。肺门截断征 2例 ,肺段肺叶锥形实变 13例 ,斑片状阴影 7例 ,胸水 15例 ,局限性胸膜肥厚 14例 ,急性肺原性心脏病 2例 ,膈肌升高 15例 ,盘状肺不张 5例。结论 影像学表现与临床表现密切结合 ,肺梗塞多能及时做出诊断。

Objectives The study was with an aim to improve our ability in the diagnosis and differential diagnosis of pulmonary infarction.Methods 20 cases of pulmonary infarction ,proved by clinical course and symptoms(such as:actue onset of chest distress,shortness of breath and dyspnea,drastic chest pain,hemoptysis and low fever ,etc)all had frontal and lateral X-ray films taken more than once;among them 14 cases had chest CT scans;4,had SPECT studies,and 9,had echocardiograms.Results 3 cases had pulmonary infarction in the upper lobar;3 in the middle lobe;and 13 in the lower lobe.Among them,6 cases were of multi-lobar distribution.2 cases had radiological signs of hilar amputation;13 showed conicalshaped consolidation of lung segments or lobes;7 had mottling shadows;15 had pleural effusion;14 had localized pleural thickening;2 cases were with corpulmonale of acute onset;elevation of hemidiaphram was shown in 15 cases,and disciform atelectasis was seen in 5.Conclusion Diagnosis of pulmonary infarction can be made in time and accurately,provided radiological sings are to be dealt with in the light of clinical features.