闭合性胸部创伤X线-CT诊断

目的：增强对闭合性胸部创伤后X线、CT征象的认识，提高正确诊断率。材料和方法：回顾分析有完整的临床及X线、CT资料的闭合性胸部创伤患者100例，对其X线、CT征象、发生机理及影像学诊断的命名进行分析讨论。结果：本组100例闭合性胸部创伤，影像学表现有以下几种（1）创伤性肺部渗出性病变（肺挫伤、轻度肺撕裂伤、湿肺）69例。（2）创伤性假性肺囊肿4例。（3）创伤性肺血肿4例。（4）创伤性肺不张2例。（5）创伤性支气管断裂1例。（6）创伤性膈疝1例。（7）纵膈和皮下气肿共30例。（8）创伤性液气胸40例。（9）肋骨骨折（单或多发）85例。锁骨和肩胛骨骨折10例。3例伴肝包膜下血肿、肝脾挫裂伤。结论：对于胸部闭合性创伤，结合临床及典型的X线、CT征象，可以明确诊断，为临床治疗提供准确依据。     

胸部外伤50例患者X线征象及动态观察

100039;2武警总院放射科,北京100039)胸部在直接或间接的暴力下均可发生肺挫伤、撕裂伤骨折等,严重者会危及患者生命。因此,及时准确地作出X线诊断,对减轻患者的痛苦、挽救患者生命有着非常重要意义。对胸部外伤的动态观察有助于了解病变的吸收治愈过程,为临床医师提供可靠的诊     

闭合性胸部创伤几个少见影像征象探讨

回顾性总结分析2002—2004年收治闭合性胸部创伤中45例影像资料较完整的病例资料。在胸部创伤患者中,X线胸片检查以肋骨骨折多见,肺、纵隔、支气管及膈肌损伤则相对少见。     

胸部非淋巴瘤性类淋巴瘤病的X线诊断

The non-lymphomatous lymphoid disorders of the chest are rare conditions characterized by infiltration of the pulmonary interstitium with lymphocytes and plasma cells. This article reported 6 pathologically proved cases, including Castleman's disease (3), pseudolymphoma (1), angioimmunoblastic lymphadenopathy (1), and lymphomatoid granulomatosis (1). The X-ray findings of these lesions were rather characteristic. In our series, the chest film showed large patchy areas of consolidation sometimes with the presence of air bronchogram in pseudolymphoma and lymphomatoid granulomatosis, simulating bronchiolo-alveolar carcinoma or pulmonary lymphoma roentgenologically. However, the former developed very slowly with little clinical symptoms. Most of the Castleman's disease in this series were found in young adults showing conspicuous, sharply marginated mediastinal node enlargement. Recognition of the aforementioned signs would bring about greater diagnostic accuracy.     

纤维支气管镜在严重胸部创伤诊断及治疗中的价值

目的 探讨纤维支气管镜(简称纤支镜)在严重胸部创伤的诊断及治疗中的价值.方法 回顾性分析我院1999年1月-2007年7月应用纤支镜进行诊断及治疗的严重胸部创伤患者114例.总共应用纤支镜检查、灌洗治疗289次.纤支镜进入途径:经鼻腔181次,气管插管32次,口腔20次,气管切口套管56次.术前、术中、术后严密监护和监测SaO:及血气分析,同时给予吸氧或呼吸机支持.结果 114例经纤支镜检查明确诊断,对102例患者进行了灌洗治疗.全部患者经1～4次纤支镜检查及灌洗后SaO2均明显提高(P<0.01),术后2 h PaO2改善明显(P<0.05).无因纤支镜检查治疗导致死亡的患者.结论 纤支镜在严重胸部创伤中有重要的诊断及治疗价值,不但可及时明确支气管损伤的诊断,而且可以有效清除气道异物、分泌物、血及痰痂,治疗阻塞性肺不张及阻塞性肺炎,明显改善呼吸功能、提高救治成功率.     

胸部外伤362例诊治分析

收治胸部外伤362例,分析其损伤原因、类型、损伤程度、合并症、处理方法及结果。其中非手术治疗330例,手术32例。174例发生胸内并发症,除1例死亡外,均恢复良好。     

Accuracy of the diagnosis of pleural effusion on supine chest X-ray

Diagnosis of pleural effusion (PE) on supine chest X-ray (SCXR) is considered difficult. This study aimed at evaluating the accuracy of the diagnosis of PE on SCXR and was performed in two phases. At phase 1, a formula for the sonographic estimation of the volume of PE was established by correlating 24 measurements (in 7 patients in whom complete drainage was achieved) with the drained volumes. At phase two, 112 consecutive SCXRs were supplemented by sonography of the chest. The films were evaluated for the presence of PE and for the presence of different radiologic signs of PE. Sonography showed PE in 41 right and 30 left hemithoraces. The overall accuracy of the diagnosis of PE on SCXR was 82 %. Only one of the undiagnosed PEs had a volume of > 300 ml. The most accurate signs were increased density of the hemithorax, blunted costophrenic angle, and loss of the hemidiaphragm silhouette. Received 31 May 1995; Revision received 9 January 1996; Accepted 12 January 1996