自发性气胸的CT评价

CT Evaluation of Spontaneous Pneumothorax

目的 分析自发性气胸的CT检查技术及其表现。资料与方法 回顾性分析 4 0例自发性气胸患者的常规CT和HRCT表现 ,并与胸腔镜下或开胸术的记录对照。结果 两肺弥漫性肺气肿 4例 ,局灶性肺大泡 36例 ,其中 5例仅见单侧肺大泡。CT显示肺大泡位于肺尖 ,沿周边胸膜下分布 ,成簇 ;无气胸侧肺大泡呈较规则的圆形气腔 ,气胸侧肺大泡不典型。所有HRCT均清楚显示病变 ,优于常规CT。结论 CT尤其HRCT有助于自发性气胸的病变显示和分类 ,可对手术处理有帮助 ,但气胸侧肺大泡常显示不典型。

Objective To discuss CT manifestations and technical points in spontaneous pneumothorax.Materials and Methods Conventional CT and HRCT findings in 40 patients with spontaneous pneumothorax were retrospectively analyzed and compared with the results found by video-assisted surgery and thoracotomy.Results Of 40 patients, bilateral diffuse emphysema was seen in 4 and localized bullae in 36, of which only unilateral bullae was seen in 5. On CT scans, the bullae were located at apices and distributed beneath peripheral pleura. The bullae were clustered at the side with pneumothorax, while the bullae displayed as irregular round air cavities at the side without pneumothorax. HRCT was superior to conventional CT in displaying the lesions.Conclusion CT, especially HRCT, is very helpful in displaying and classifying the lesions causing spontaneous pneumothorax, and also in guiding clinical management. The fact worthy to be mentioned is that the bullae at the side with pneumothorax usually have atypical appearance.