胸部闭合性损伤的CT诊断及临床价值

回顾性分析185例胸部闭合性损伤患者的临床、x线及CT表现。胸部闭合性损伤包括肺挫伤185例，其中合并肺撕裂伤35例，Macklin效应5例，肺疝1例。肺挫伤CT表现为肺纹理增粗、模糊9例，小点状影12例，斑片状影48例，小片状影10例，磨玻璃影16例，大片状或肺段影5例，广泛性云絮状影17例，混合性病灶68例。肺撕裂伤表现为肺血肿8例（12个病灶），肺气囊腔14例（19个病灶），液气囊腔25例（53个病灶）。支气管血管束周围条状气体密度影5例；含气的肺组织疝人右侧前胸壁皮下组织内1例。首次CT漏诊肺挫伤1例，肺撕裂伤2例。

Diagnostic value of CT scan for closed chest injury

CT findings and complete clinical data of 185 cases with closed chest injuries were retrospectively analyzed.The diagnosis of 185 cases were pulmonary contusion ( n = 185 ),pulmonary laceration ( n = 35 ),Macklin effect ( n = 5 ) and lung herniation ( n = 1 ).CT findings of lung contusion appeared as thick and vagur lung marking (n =9),small points shadows (n = 12 ),blotchy shadows (n =48),small pieces shadows (n=10),ground-glass shadows (n=16),large pieces shadows (n =5),diffuse patchy clouding shadows (n = 17) or mixed lesions (n = 68).CT appearance of lung laceration included pulmonary hematomas (n = 12),cavitary lesions with air ( n = 19),cavitary lesions with air-fluid levels ( n = 53 ).Macklin effect appeared as bronchus-,pulmonary vessel-adjacent air collection and mediastinal air collection (n=5).Traumatic pulmonary hernia appeared as lung herniation through an intercostal space.Initial CT scan missed one case of pulmonary contusion and 2 cases of pulmonary laceration.