心源性肺水肿的CT征象分析

目的分析心源性肺水肿患者的肺CT影像学表现,从而提高心源性肺水肿患者的临床认识。方法自2010年1月至2013年1月收治的100例心源性肺水肿患者,以发病时间不超过24小时为限,分为急性心源性肺水肿与慢性心源性肺水肿。以心脏超声射血分数EF值≥45%为限,分为左室射血分数正常心衰与左室射血分数减低心衰。对患者的危险因素、临床特征以及肺CT表现进行分析。结果急性心源性肺水肿多见左室射血分数减低心衰患者。肺CT影像学表现为腺泡结节、斑片状及大片融合影,有时可见空气支气管像,病变边缘模糊。病变进展时双肺出现广泛的密度均匀实变阴影,典型者出现"蝶翼征"。慢性心源性肺水肿多见左室射血分数正常心衰患者,肺部CT影像学表现以肺纹理增多,增重,胸膜下线、克氏线出现以及肺实质磨玻璃样变等间质性肺水肿改变为主。结论心源性肺水肿患者临床起病时间急缓,EF指数的高低与肺部CT表现密切相关。早期识别其影像学表现有助于临床提高诊断率。

The Lung CT Imaging Features of Patients with Cardiogenic Pulmonary Edema

Objective To investigate the lung CT imaging features of patients with cardiogenic pulmonary edema ,thereby enhancing diagnostic accuracy in patients with the cardiogenic pulmonary edema.Methods From January 2010 to January 2013 were treated 100 cases of cardiogenic pulmonary edema, with onset time is limited to less than 24 hours, divided into acute cardiogenic pulmonary edema and chronic cardiogenic pulmonary edema. EF, ejection fraction by echocardiography is limited≥45%, divided into heart failure with normal left ventricular ejection fraction and heart failure with left ventricular reduceded jection fraction. The patient＆#39;s risk factors, clinical features and lung CT findings were analyzed.Results Pulmonary edema has variable manifestations. acute cardiogenic pulmonary edema often occurred in patients with heart failure reduced left ventricular ejection fraction. CT imaging of lung typically manifests radiologically as acinar nodules, patchy and large fusion shadow, sometimes visible as air bronchial lesion,edge blur. Lung lesions indicates worsening disease when extensive consolidation of uniform density shadow occured, the typical feature manifests as a ＂bat wing edema.＂ chronic cardiogenic pulmonary edema more occurred in patients with heart failure normal left ventricular ejection fraction, pulmonary CT imaging with increased lung markings, thickened septal lines,numeropus Kerley lines, peribronchial cuffing and lung parenchyma appeared GGO and other interstitial changes in the main pulmonary edema.Conclusion The clinical onset time, EF index in patients with Cardiogenic pulmonary edema are closely correlated with pulmonary CT findings. Early recognition of their imaging findings help clinicians improve diagnostic yield.