摘要
目的分析自发性气胸的胸膜窗MSCT和CT仿真内镜(CTVE)表现。方法收集73例自发性气胸患者MSCT资料,以气囊为中心行薄层(层厚1mm)MPR及CTVE重建,观察胸膜窗大小、位置、胸膜面缺损或龛影形态及其与胸腔的连通关系。结果 73例自发性气胸患者中,MSCT薄层重建图像检出15例患者27个胸膜窗;左侧11例,右侧4例;多见于肺尖(15/27,55.56%),其次为前胸壁(7/27,25.93%)和纵隔面(5/27,18.52%);23个(23/27,85.19%)可显示胸膜窗与胸腔的连通关系。胸膜窗均表现为壁层胸膜局限性缺损伴气囊突出,呈类圆形、椭圆形、短柱状或曲棍球状;CTVE正面观呈类圆或椭圆形,19个胸膜窗可直视气囊底部,6个胸膜窗侧壁平坦呈坑道状,其余胸膜窗侧壁多呈洞穴状。结论胸膜窗常表现为壁层胸膜面小憩室样改变,其发病可能与局部胸腔负压增高、胸膜损伤有关。
Objective To observe the manifestations of MSCT and CT virtual endoscopy（CTVE）images of pleural windows in spontaneous pneumothorax.Methods MSCT data of 73 patients of spontaneous pneumothorax were analyzed.Taking pneumatized sac as the center,thin cross-sectional planer（1 mm thickness）MPR and CTVE were reconstructed.Then the size and location of pleural windows,form of pleural surface defect or niche and the relationship with the chest were observed.Results In all 73 patients of spontaneous pneumothorax,27 pleural windows were detected in 15 patients with MSCT thin cross-sectional planer reconstruction image.Pleural windows were observed on the left side in 11 patients,while on the right side in 4 patients.Most of pleural windows located at apex（15/27,55.56%）,followed by anterior chest wall（7/27,25.93%）and mediastinum（5/27,18.52%）.The connection of pleura window with thorax was shown in 23（23/27,85.19%）.Small defection on parietal pleural with pneumatized sac bulging was seen in all pleural windows,with circular,elliptic,short columnar or hockey shapes.On the front view of CTVE,pleural windows showed niche on parietal pleural surface with round or oval form,and the bottom of the pneumatized sac could be straightly seen in 19 pleural windows.The walls were flat,tunnel shaped in 6 pleural windows,while cavernous shaped in other pleural windows.Conclusion Pleural windows often displayed as small diverticulum-like shadows on parietal pleural surfaces,and the pathogenesis might be associated with negative pressure increased in local pleural cavity and pleural damages.
作者
曹和涛
成月
夏振铎
吴献华
CAO Hetao;CHENG Yue;XIA Zhenduo;WU Xianhua(Department of Medical Imaging,the Affiliated Hospital of Nantong MedicalCollege,Nantong 226001,China)
出处
《中国医学影像技术》
CSCD
北大核心
2018年第6期865-868,共4页
Chinese Journal of Medical Imaging Technology
