ISSN 1004-4140
CN 11-3017/P
张海平, 吴晓华, 赵田瑞, 等. 急性肺动脉栓塞继发肺梗死CT特征分析[J]. CT理论与应用研究, 2022, 31(2): 227-235. DOI: 10.15953/j.ctta.2021.018.
引用本文: 张海平, 吴晓华, 赵田瑞, 等. 急性肺动脉栓塞继发肺梗死CT特征分析[J]. CT理论与应用研究, 2022, 31(2): 227-235. DOI: 10.15953/j.ctta.2021.018.
ZHANG H P, WU X H, ZHAO T R, et al. CT manifestations of pulmonary infarction secondary to acute pulmonary embolism[J]. CT Theory and Applications, 2022, 31(2): 227-235. DOI: 10.15953/j.ctta.2021.018. (in Chinese).
Citation: ZHANG H P, WU X H, ZHAO T R, et al. CT manifestations of pulmonary infarction secondary to acute pulmonary embolism[J]. CT Theory and Applications, 2022, 31(2): 227-235. DOI: 10.15953/j.ctta.2021.018. (in Chinese).

急性肺动脉栓塞继发肺梗死CT特征分析

CT Manifestations of Pulmonary Infarction Secondary to Acute Pulmonary Embolism

  • 摘要: 目的:探讨急性肺动脉栓塞(APE)继发肺梗死(PI)CT特征。方法:回顾性分析41例APE继发PI患者的临床及CT资料,总结PI的数量、位置、形态、边缘、胸腔积液及其动态变化特征。结果:PI的CT特征:①数量及位置:共79个PI病灶,18例患者为单发PI,23例患者为多发;所有PI病灶均位于胸膜下,与胸膜呈宽基底相连;46.8%(37/79)位于右肺下叶,36.7%(29/79)位于左肺下叶,右肺上叶、中叶分别为3.8%(3/79)、6.3%(5/79),左肺上叶舌段6.3%(5/79)。②形态:45.6%(36/79)病灶表现为反晕征(RHS),36.7%(29/79)为椭圆形、楔形及驼峰样实变,17.7%(14/79)为斑片状磨玻璃影。③支气管血管束包埋征:79.7%(63/79)病变内可见支气管血管束走行其中,21.3%(16/79)病变范围较小,其内未见明确支气管血管束走行、包埋。④增强后,79个PI病灶均未见强化。⑤治疗后期,所有PI病灶均演变为斑片或索条影。⑥胸腔积液:63.4%(26/41)患者出现胸腔积液,42.3%(11/26)为双侧胸腔积液,57.7%(15/26)单侧胸腔积液。结论:APE继发PI的CT表现具有一定特征性,胸膜下出现单发或多发病变,有反晕征、楔形或驼峰样实变、支气管血管束包埋特征时应考虑到PI,另外胸腔积液有助于诊断。

     

    Abstract: Objective: To investigate the CT findings of pulmonary infarction (PI) secondary to acute pulmonary embolism (APE). Method: The clinical and CT data of 41 patients with PI secondary to APE were analyzed retrospectively. The number, location, shape, margin of PI, pleural effusion and dynamic changes were summarized. Results: CT features of PI: (1) Number and location: Among the total 79 PI lesions, 18 patients had single lesion and 23 patients had multiple lesions. All lesions were located under the pleura and connected to the pleura with a broad base, 46.8% (37/79) were located in the lower lobe of the right lung, 36.7% (29/79) in the lower lobe of the left lung, 3.8% (3/79) in the upper lobe, 6.3% (5/79) in the middle lobe of the right lung, and 6.3% (5/79) in the lingual segment of the upper lobe of the left lung. (2) Shape: 45.6% (36/79) of the lesions showed Reversed Halo Sign (RHS), 36.7% (29/79) displayed consolidation of oval, wedge or hump, 17.7% (14/79) revealed ground glass opacity. (3) Bronchovascular bundles in PI: Bronchovascular bundles were found in 79.7% (63/79) of PI. In 21.3% (16/79) of the cases, there was no bronchovascular bundle in the lesion because of its small size; (4) After enhancement, there was no enhancement shown in the 79 PI lesions. (5) All 79 lesions changed into patchy or linear during the end of the treatment period. (6) Pleural effusion: 63.4% (26/41) of patients had pleural effusion, among whom 42.3% (11/26) had bilateral pleural effusion, and 57.7% (15/26) had unilateral pleural effusion. Conclusion: The imaging manifeatations of PE secondary to API hole certain characteristics. For single or multiple lesions under the pleura, with RHS, consolidation of wedge or hump, bronchovascular bundles, APE secondary to API should be considered. In addition, pleural effusion is helpful for diagnosis.

     

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