气管支气管破裂的CT诊断

目的:探讨CT对气管支气管破裂的诊断价值水平.方法:回顾性分析22例气管支气管破裂患者的临床、胸片及CT影像资料,其中外伤性12例,自发性10例.结果:X线片诊断颈肩部皮下及纵隔气肿3例,可疑纵隔气肿8例,气胸4例,胸腔积液2例,肋骨骨折2例,均未能提示气管支气管破裂.CT诊断颈肩部皮下及纵隔气肿18例,气胸6例,胸腔积血4例,肋骨骨折2例,肺挫伤4例,肺气囊1例;CT发现气管或支气管破裂22例(23处);支气管破裂口宽1～3mm,气管破裂口宽1～12mm,涉及管腔周径均<50%,其中2例气管裂口纵径分别为28和40 mm.破裂部位位于气管5例,其中外伤性2例,自发性3例;位于右主支气管8例(9处),位于右上叶后段支气管4例,位于左主支气管5例.10例外伤性支气管破裂均发生在右侧,自发性支气管破裂5例发生在左侧,2例发生在右侧;主支气管破裂均在隆突附近1.0～2.5 cm范围内.结论:胸部CT对气管支气管破裂的定位明显优于胸片,对明确诊断有重要价值.

CTdiagnosis of tracheo bronchial rupture

Objective：To study the CT finding of tracheo bronchial rupture.Methods：Radiographs and CT,images of twenty-two cases of tracheo bronchial rupture were retrospectively analyzed,including 12 cases of traumatic rupture and 10 cases of spontaneous rupture.Results：Chest X-ray revealed neck shoulder and mediastinal emphysema in 3 cases,suspicious mediastinal emphysema 8 cases,pneumothorax in 4 cases,Pleural effusion 2 cases,rib fracture 2 cases;no difinite rupture of trachea and bronchi was observed.CT showed subcutaneous and mediastinal emphysema in 18 cases,pneumothorax in 6 cases,hemo-thorax in 4 cases,rib fracture in 2 cases,pulmonary contusion in 4 cases,pulmonary bulla in one case;rupture of trachea a bronchial was detected in 22 cases.The size and location of the openings of rupture could be well demonstrated on CT image with multiplanar refomation.Conclusion：Chest CT scanning in superior to chest X-ray in demonstrating the location and size of rupture of trachea and bronchial,CT than important value for the diagnosis.