ISSN 1004-4140
CN 11-3017/P

多发创伤性肺假性囊肿的CT动态观察

CT Dynamic Analysis of Multiple Traumatic Pulmonary Pseudo-cysts

  • 摘要: 目的:探讨多发创伤性假性肺囊肿的CT表现及随访变化规律。方法:回顾性分析30例临床和影像学随访证实的多发创伤性假性肺囊肿患者的资料。结果:30例胸部多合并肺挫伤、肋骨骨折、血气胸。本组创伤性假性囊肿均为多发,平均4.6个病灶,大小:2mm×4mm~13.5cm×6.2cm。首次CT距外伤后1小时~5天,随访1天~15月,平均4.3月。首次CT可表现为多发单纯血肿、肺挫伤合并多发血肿、肺挫伤合并多发气囊囊肿或气液囊肿。随访中近胸膜下血肿可因血肿破裂或肋骨骨折造成的迟发性气胸等原因内部再出现气囊改变,单纯性血肿可在随访中表现为含气或不含气,其余含气病灶多渐变小、变实,直至完全吸收或后遗疤痕索条。液囊可为单纯性或合并晕征。气液囊可表现为楔形征、银镯征、进水皮球征或杯中液体征、花生壳征、三角烧瓶征等征象。3例首次CT检查后2小时内死亡,死亡原因2例为合并广泛挫伤及气胸,1例合并肝脾出血。其余病例除针对伴发疾病对症治疗外,肺假性囊肿均经保守治疗治愈,囊肿吸收时间长短多与大小呈正相关。结论:CT可清晰显示多发创伤性假性肺囊肿的形态及演变、伴发症,是本病首选的影像学检查方法。

     

    Abstract: Objective:To investigate the CT findings and follow-up variation of multiple traumatic lung pseudo-cysts.Methods:The data of 30 cases of multiple traumatic pseudo lung cysts confirmed by clinical and imaging follow-up were retrospectively analyzed.Results:Most cases combined with pulmonary contusion,rib fractures,hemopneumothorax.Traumatic pseudocysts in all cases are multiple,an average of 4.6 lesions,size:4mm ×6 mm~13.5 cm × 6.2 cm.First CT examination from 1 hour to 5 days after trauma,and were followed up for 1 day to 15 months,with an average of 4.3 months.The first CT may show multiple simple hematoma,pulmonary contusion merging with multiple hematomas,pulmonary contusion merging with balloon cyst or liquid cyst,multiple airbags cyst or gas cyst.The hematomas lesions near pleural may appear airbag changes again due to hematoma rupture or delayed pneumothorax by rib fractures or other reasons.In the follow-up CT,the simple hematomas may contain with gas or without gas,the rest of the gas-containing lesions may become smaller and consolidation gradually,until completely absorbed or residual cicatricial band.Liquid cysts may be simple or complicated with halo sign.Gas-liquid cysts may appear wedge-shaped sign,silver bracelet sign,water in ball sign or the liquid in the cup sign,peanut shell sign,triangle flask sign and other signs.3 patients died after the CT examination within 2 hours,due to extensive pulmonary contusion and wet lung in 2 cases,liver and spleen bleeding in 1 case.The remaining cases received symptomatic treatment aimed at the accompanying;pulmonary pseudo-cysts were cured by conservative treatment.The absorption time of cysts was positively correlated with the length and size.Conclusion:CT can clearly show the forms,the evolution and the complications of the multiple traumatic lung pseudo-cysts,so it is the best imaging examination method for the diagnosis.

     

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