放射性肺损伤的影像学诊断(附70例分析)

目的:探讨放射性肺损伤(Irradiation lung injury ILI)的影像学表现及其诊断价值。方法:分析了70例经临床和影像学证实的ILI的影像学表现与放射剂量、放射方法、放射面积、放射野、放射速度之间的关系。结果:急性期ILI的X线胸片表现为:血管纹理周围模糊阴影或斑片状均匀实变影,可融合为片状,病变范围与照射野相符。CT表现为放射野内出现斑片状或磨玻璃状阴影,与正常组织分界平直而且清楚,内有“含气支气管征”。慢性期或纤维化期ILI的X线胸片表现为放射野内见到条索状阴影,肺体积缩小,病变与正常肺组织间呈锐利直边。CT表现为与放射野一致的条索状阴影,行四野照射的病人可见到“十字征”。结论:高分辨率CT诊断ILI较之X线平片更为敏感且更具特征,可达到早期诊断与及时治疗之目的。

The imaging diagnosis of irradiation lung injury (Report of 70 cases)

Objective:To study the imaging appearance of irradiation lung injury(ILI) and its diagnostic value.Methods: Seventy cases with ILI confirmed by clinic and imaging were explored the relationship to radiation dose,methods,the area,the radiation field and velocity retrospectively.Results: The chest X-ray finding of acute ILI were hazy lesion around the markings of vessel or patchy homogeneous consolidation opacities which could be confluent to massive.The extent of ILI was coincidence with radiation field.The CT appearance of acute ILI were patchy or ground glass opacities in the radial field.It's border to normal lung were flat and clear.The chest X-ray finding of chronic or fibrosis period of ILI were streaky or coarse reticular pattern opacities in the radiation field.The edge with normal lung were flat and sharp.The cross streaky opacities coincidence with two radiation field which were meet with right angle.It was called "cross sign".Conclusion: HRCT are more sensitive and can catch the characteristic appearance.So it can to make early diagnosis and timely treatment.