心源性肺淤血肺水肿的影像特征分析

Imaging features of cardiogenic pulmonary congestion and pulmonary edema

目的探讨心源性肺淤血肺水肿的影像特征,为临床诊断提供更多可靠依据。方法以我院收治的100例心源性肺淤血肺水肿患者为研究对象,采用回顾法对相关资料展开分析,探讨其影像特征。结果通过影像分析发现,其中心脏增大96例(96.0%)、肺血转流40例(40.0%)。肺淤血改变44例(44.0%)。间质性肺水肿53例(53.0%),包括了支气管袖口22例(22.0%)和Kelery B、A、C线31例(31.0%),表现为肺纹理和肺门血管增粗、模糊,肺部小叶间隔线、胸膜下线的出现,支气管血管束增粗增多,支气管袖口征及小叶间隔呈光滑型增厚。肺泡性水肿40例(40.0%),表现为密度逐渐增高的薄纱样、云雾状以及云白样片状渗出影,典型表现为以肺门为中心的蝶翼样片状密度增高影,其中磨玻璃影或/和气腔实变以及边缘模糊19例(19.0%),蝶翼征21例(21.0%)。出现胸腔积液75例(75.0%)。结论心源性肺淤血和肺水肿改变在影像中早于临床,具有发展迅速和变化复杂的特点,通过对肺水肿胸部影像进行分析,能为医师的临床诊断提供更多可靠依据,有助于提升临床治疗效果。

Objective To analyze the imaging features of cardiogenic pulmonary congestion and pulmonary edema for more reliable clinical diagnosis.Methods One hundred patients with cardiogenic pulmonary congestion and pulmonary edema admitted to our hospital were enrolled in this study and their imaging features were retrospectively analyzed.Results From the images,cardiac enlargement was found in 96 cases(96.0%),pulmonary blood bypass in 40 cases(40.0%),pulmonary congestion in 44 cases(44.0%),and interstitial pulmonary edema in 53 cases(53.0%),including bronchial sleeve sign in 22 cases(22.0%)and Kelery B,A,and C line in 31 cases(31.0%),which were shown as thickening and blurring of the pulmonary texture and the portopulmonary blood vessels,occurrence of pulmonary interlobular septum line and subpleura line,thickening and increasing of bronchial vascular bundles,occurrence of bronchial sleeve sign,and thickening of the interlobular septum in a smooth type.Alveolar edema occurred in 40 cases(40.0%),showing as gradually increasing density of thin gauzes and cloud-like or cloud-white flake exudation.The typical manifestation was increased pterygoid density centering on the hilar of the lungs.Among them,19 cases(19.0%)had ground glass shadow/cavity consolidation and blurring edge and 21 cases(21.0%)had butterfly wing sign.Pleural effusions occurred in 75 cases(75.0%).Conclusion The imaging changes of pulmonary congestion and pulmonary edema are earlier than the clinical changes,which are rapidly developed and complexly changed.Through analyzing the chest edema images,more reliable bases can be found for the doctor′s clinical diagnosis and for improving the clinical treatment outcome.