心力衰竭患者胸部CT征象及其临床意义分析

The analysis of CT imaging features and clinical significance of patients with heart failure

目的通过对心力衰竭患者的胸部CT征象进行回顾性分析,提高心力衰竭患者的临床诊断率。方法 2015年1月~2016年5月在我院就诊并经临床确诊的心力衰竭患者80例,根据心力衰竭发生的时间、速度、严重程度将患者分为急性心力衰竭组(37例)及慢性心力衰竭组(43例),分析80例患者的临床症状及CT影像资料,对两组心力衰竭患者胸部CT影像学特点进行对比分析。结果急性心力衰竭组患者胸部CT多表现为肺泡性肺水肿,双肺野中内带呈现斑片状或云雾状密度增高影,内部可见支气管充气征,病变进展期大多数表现为双肺广泛密度实变影,少数病例可见"蝶翼征"。慢性心力衰竭组患者胸部CT表现以间质性肺水肿为主,表现为小叶间隔及支气管壁的增厚,支气管血管束以及肺门模糊、增粗,并可见磨玻璃影。两组患者多数可见心脏外形的增大(49/80),少量心包积液(47/80)及胸腔积液(41/80),胸腔积液多为双侧性且右侧量多于左侧量。结论胸部CT检查能够显示急、慢性心力衰竭患者的特征性影像学表现,可为心力衰竭的临床诊治提供可靠依据。

Objective To improve the clinical diagnostic rate of patients with heart failure,through the retrospective analysis of their lung CT imaging features. Methods 80 patients with clinically diagnosed heart failure in our hospital from January 2015 to May 2016 were divided into acute heart failure group（ 37 cases） and chronic heart failure group（ 43 cases） according to the onset time,speed and severity of heart failure. The clinical and CT imaging data of 80 patients with heart failure were analyzed,and the lung CT imaging features of two groups were compared and analyzed. Results The lung CT imaging features in patients with acute heart failure was characterized by pulmonary alveolar pulmonary edema. The patchy and shadow density increase were present in both lung field,and their inner zone could be found visible bronchial inflation sign. A few cases can appear ＂ butterfly wing＂,while,most of the cases performanced as wide solid lesion shadow in double lung for patients with advanced stage. The lung CT imaging features in patients with chronic heart failure were characterized by pulmonary interstitial edema,which showed interlobular septal and bronchial wall thickening,bronchial vascular bundle and hilar fuzzy and thickening and the ground-glass opacity. The increase of heart shape（ 49/80）,a small amount of pericardial effusion（ 47/80） and pleural effusion（ 41/80） were appearanced in the majority patients in both groups. The pleural effusion was bilateral and the right amount was more than the left.Conclusion Lung CT examination can show the imaging performance characteristics in patients with acute and chronic heart failure,which can provid strong and reliable basis for clinical diagnosis and treatment of acute and chronic heart failure.