高原肺水肿影像表现及其病理基础的实验研究

目的探讨高原肺水肿的影像特点及其病理基础.材料与方法利用减压舱模拟海拔7000m高原条件观察家猫缺氧24、48和72小时胸部X线、CT表现及其病理改变.结果实验性高原肺水肿早期X线、CT表现为肺纹理增粗、模糊,肺野周围性分布的斑片状阴影.减压组动物减压后右下肺动脉横径较减压前显著增加(P＜0.05),胸片肺水肿记分与CT值呈显著的线性正相关(r=0.955).主要病理改变为肺出血及肺水肿.结论高原肺水肿胸部X线、CT主要表现为肺野周围性分布的斑片状阴影,对高原肺水肿的诊断有重要意义.

Experimental Study on Image Features and Pathologic Basis of High Altitude Pulmonary Edema

Purpose: To investigate chest image appearances of high altitude pulmonary edema (HAPE) and it's pathologic bases. Materials and Methods: A model of hypobaric hypoxia simulated 7000m was performed on 30 cats. Chest radiography, computed tomography (CT) and pathologic findings of the experimental cats were observed at 24, 48 and 72h after hypoxia. Results: In the earlier stage of HAPE, the imaging feaures of experimental HAPE showed that lung markings and patchy shadows increased in peripheral lung field. Compared with prehypobaric hypoxia, transverse diameter of right descending pulmonary artery (RDPA) of the posthypobaric aminals increased significantly (P<0 05). The pulmonary edematous code of chest radiography were significantly positively correlated with CT value (P<0.001). Patholgic examinations showed that the major changes of experimental HAPE were pulmonary hemorrhage and pulmonary edema. Conclusion: The radiographic characteristics of HAPE are peripheral patchy shadows which are often situated at superior lung, Chest radiography and CT which can truly reflect pathologic changes of HAPE have value in diagnosing HAPE.