X线与CT诊断自发性纵隔气肿的对比研究

发布时间：2018-07-28 20:44

【摘要】：目的探讨X线与CT诊断自发性纵隔气肿的征象及价值。方法回顾性分析本院门诊及呼吸科治疗的自发性纵隔气肿8例临床资料,其中4例患者均进行了CT及X线图像摄片且经CT确诊。结果 CT图像显示纵隔内沿气管、支气管、心脏、大血管及食管等组织结构周围间隙存在散乱的气体影,前纵隔气肿2例,中纵隔气肿1例,后纵隔气肿1例;伴有颈、胸部皮下气肿2例,胸腔积液1例,肺窗图像显示胸膜被气体向肺野方向不同程度推移。自发性纵隔气肿的后前位X线图像显示纵隔结缔组织间隙存在条状气体影,纵隔气肿下扩散至心脏及隔肌之间,导致双侧横隔与纵隔呈现连续的充气状,侧位X线片与正位X线片更易显示纵隔形状,表现为纵隔旁线条状透亮影,胸骨与心脏间的透亮区增大,经阅片医师诊断,X线诊断准确率为75%,CT诊断符合率为100%。结论后前位X线图像显示纵隔结缔组织间隙存在条状气体影,纵隔气肿下扩散至心脏及隔肌之间及隔连续症,在排除气胸的情况下,诊断自发性纵隔气肿有一定的特异性,X线凭借着方便、快捷、廉价的特点可作为早期筛查自发性纵隔气肿,在高度怀疑的情况下,有条件的医院应采用CT明确诊断,条件不足的社区及基层医院应加摄侧位胸片明确诊断。
[Abstract]:Objective to study the signs and value of X-ray and CT in diagnosis of spontaneous mediastinal emphysema. Methods the clinical data of 8 cases of spontaneous mediastinal emphysema treated in outpatient and respiratory department in our hospital were analyzed retrospectively. Results CT images showed that there were scattered gas shadows in mediastinal mediastinum along the space around the trachea, bronchus, heart, great blood vessel and esophagus, 2 cases of anterior mediastinal emphysema, 1 case of middle mediastinal emphysema, 1 case of posterior mediastinal emphysema, and 1 case of posterior mediastinal emphysema. There were 2 cases of subcutaneous emphysema and 1 case of pleural effusion. The posterior anterior X-ray images of spontaneous mediastinal emphysema showed that there were strip gas shadows in the space of mediastinal connective tissue, and the mediastinal emphysema spread between the heart and the septum, resulting in the bilateral mediastinal septum and mediastinum showing a continuous inflatable shape. Lateral and positive radiographs were easier to display mediastinal shape, showing parastastinal line transparency, enlarged clear area between sternum and heart. The accuracy of X-ray diagnosis by radiographs was 75% and the accuracy rate of CT diagnosis was 100%. Conclusion the posterior anterior X-ray images showed that there were strip gas shadows in the space of mediastinal connective tissue, and the mediastinal emphysema spread between the heart and septum and the septum continuous, and the pneumothorax was excluded. The diagnosis of spontaneous mediastinal emphysema has some specific X-ray features. It can be used as an early screening method for spontaneous mediastinal emphysema because of its convenient, fast and cheap features. In the case of high suspicion, the hospital with conditions should use CT to make a definite diagnosis. Community and primary hospitals with insufficient conditions should be diagnosed by lateral chest radiography.
【作者单位】：佛山市顺德区大良医院放射科;
【分类号】：R564;R816.4

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