新生儿气胸并纵隔积气的X线诊断

目的 分析新生儿气胸并纵隔积气的X线表现及特点,提高其诊断水平.方法 47例患者均摄有仰卧前后位胸腹联合片,20例同时摄有仰卧水平侧位片,1例行胸部CT检查,45例有一次或多次随访.结果 47例新生儿气胸中,胸腔前缘积气20例,肋膈角区积气1 5例,纵隔旁积气12例,同时伴有纵隔内积气11例.新生儿多采用仰卧位及卧水平侧位摄片,其气胸和纵隔积气的X线表现与年长儿、成人立位摄片时表现不同,气体多聚集在胸腔前部、肋膈角区及前纵隔旁,X线多表现为一侧胸腔密度降低,中内带明显,同时可见压缩肺边缘,肋膈角异常锐利变深,纵隔心影旁或膈顶部异常清晰锐利;纵隔积气表现胸腺上抬,远离心底部,称为“胸腺帆征”,胸腺边缘清晰,见“八”字征.结论 根据新生儿气胸的X线表现特点,X线可明确新生儿气胸、纵隔积气的诊断.

The X-ray diagnosis of neonatal pneumothorax and pneumomediast

Objective To improve the diagnostic level by the analysis of the X-ray findings and characteristics of neonatal pneumothorax and mediastinal gas.Methods 47 patients were all taken supine anteroposterior chest and abdomen piece,20 cases were taken lateral radiograph,1 case was taken CT chest examination,45 cases had one or more follow-up.Results Among 47 cases of neonatal pneumothorax,20 cases had anterior gas of chest,15 cases had costophrenic angle edge gas,12 cases had gas adjacent to mediastinum,and 11 cases had gas in mediastinum.Conclusion Due to neonate adopt supine and lateral position,the X-ray findings are different from order children and adults,the gas is gathered at the anterior of chest,costophrenic angle area and anterior mediastinum,the X-ray features are one-side of the chest cavity density decreased significantly within the visible compression of the lung edge,costophrenic angle become deeper and sharper,the mediastinal heart shadow and the top of diaphragm are sharp;pneumomediastinum performance thymus elevation,far away from the bottom of heart,known as the "thymic sail sign",the thymus had sharp edges,appeared "8" sign.Combination of performance characteristics of the X-ray,neonatal pneumothorax pneumomediastinum can confirm the diagnosis.