目的 探讨胸部闭合性肺实质损伤的影像学表现.方法 回顾性分析了68例胸部闭合性肺实质损伤患者的影像学资料.结果 胸部闭合性肺实质损伤的影像学表现主要归纳为:①肺挫伤36例,影像学表现为肺纹理增多增粗,伴有斑点状、斑片状密度增高影;大片状密度增高影;磨玻璃样改变;②肺撕裂伤22例,影像学表现为边缘光滑的空洞样团块影;边缘模糊的团片状密度增高影,其内夹杂密度减低区,囊腔内可见气-液平面;③肺血肿10例:表现为圆形或椭圆形团块影,边缘尚清楚,可有分叶,周围略高于中心.肺外表现:血气胸28例、皮下气肿或纵隔气肿15例、单纯性气胸6例.结论 影像学检查是发现、诊断和动态观察胸部闭合性肺实质损伤的最佳方法,典型的肺实质损伤单凭X线平片、CT、外伤史即可诊断,但CT优于X线平片.%Objective To investigate imaging manifestations of blunt chest pulmonary parenchyma injury. Methods Imaging data of 68 patients with blunt chest pulmonary parenchyma injury were retrospectively analyzed, Results The imaging manifestations of such a type injury were embodied in the followings. ① Pulmonary contusion (n=36); images showed increased lung markings and thickening, accompanied by patchy and high density shadow, large sheet density shadow, and ground-glass like changes ② Pulmonary laceration (n=22): image showed smooth-edged hole-like clump shadow and the sheet density shadow group with blurred edges, in which thereduced density areas and gas-liquid surface can be seen in cystsi ③ Pulmonary hematoma (n=10): image showed round or oval mass shadows with clear edge, some of which had lobes, and surrounding area was slightly higher than the center. With respect to the extrapulmonary manifestations, there were 28 cases of hemopneumothorax. 15 cases of subcutaneous emphysema or mediastinal emphysema, and 6 cases of simple pneumothorax. Conclusion Medical imaging is the best way for the detection, diagnosis and dynamic observation of this disorder. While the typical pulmonary parenchyma injury can be diagnosed by X-ray. CT and injury history, CT is superior to X-ray film.
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