原发性自发性气胸的DR数字化X线摄影影像表现再分析

摘要

目的：分析原发性自发性气胸的DR影像表现，为临床诊治提供更多帮助。方法选取我院2012年1月-2013年6月收治的经胸腔镜下或开胸术治愈的原发性自发性气胸患者42例，收集临床资料，进行回顾分析，并将术图（病案记录）中破裂漏气的肺大疱部位与DR影像表现作一一比对。结果本组术中破裂漏气的肺大疱部位明确，位于左肺尖段21例、左肺舌段1例、左肺背段1例、右肺尖段18例、右肺背段1例；病灶肺大疱为数个聚集分布或成串分布，直径约0．5～5 cm之间不等，表面覆盖脓苔。影像表现为破裂漏气病灶区域呈细结节样、粗糙线样、或不规则波浪线样密度增高影，即光滑纤细的发线样肺压缩边缘突然呈细结节样、粗糙线样、或不规则波浪线样改变，与手术记录符合率约83％（35/42例）。结论 DR数字化X线摄影的胸正位图像对原发性自发性气胸的显示率为100％，仔细沿着肺压缩边缘观察发现局部细结节样、粗糙线样、或不规则波浪线样异常征象的部位，能估测破裂漏气的肺大疱病灶部位，为胸腔镜下或开胸术治疗提供更有价值的手术入路信息。%Objective To analyze primary spontaneous pneumothorax manifestation in DR image and provide more valua -ble information for clinical diagnosis and treatment .Methods 42 cases of patients with primary spontaneous pneumothorax were selected and retrospectively analyzed who had been hospitalized in our hospital from January 2012 to June 2013 and cured by under thoracoscope treatment or thoracotomy .The ruptured leaking pulmonary bulla areas in the operation diagram ( case re-cord ) were compared with the DR image manifestations .Results The leaking areas of pulmonary bulla in this group were well defined.They were located respectively in the left apical segment ( 21 cases),the left lung tongue segment (1 case),the left lung back segment(1 case),the right apical segment(18 cases), the right lung back segment (1 case).Pulmonary bullae in the focus were in aggregated distribution or in cluster distribution ,0.5~5 cm in diameter,covered with pus.The imaging dem-onstrated that the ruptured leaking focus took the shape of fine nodules ,rough lines,and irregular waves,with the line density increased,which coincided with the operation record ,with the coincidence rate of about 83% (35/42).Conclusion DR chest image of digital X-ray photography has a display rate of 100% for the primary spontaneous pneumothorax .Under close observation ,along the edge of the compressed lung can be seen localized areas of abnormal signs with fine nodules ,coarse lines or irregular waves , which can serve as the basis for the detection of ruptured leaking focus ,thus providing valuable information of surgical approach for thoracoscope treatment or thoracotomy .