高原颅脑枪弹伤肺部损伤远达效应CT及HRCT影像病理对照研究

发布时间：2018-07-29 08:48

【摘要】：目的　探讨高原颅脑枪弹伤肺部远达效应的CT及HRCT表现及其病理基础。方法　高原适应猪 18只 ,分实验 (12只 )、对照 (6只 ) 2组。国产 5 .80mm弹道枪 ,造成猪右脑贯通伤。行胸部CT及HRCT扫描 ,制作充气固定肺标本、病理大切片和常规病理切片。逐级对照CT、HRCT、充气固定肺标本HRCT、病理大切片和常规病理切片相应表现。结果　 (1)CT示肺叶、段或亚段实变 ;支气管血管束边缘毛糙、模糊 ,周边肺野呈磨玻璃样改变 ;肺不张。 (2 )HRCT见部分肺小叶实变、气肿、磨玻璃样改变 ;小叶间隔、小叶核增厚 ,增粗。 (3 )活体动物HRCT扫描所见征象均可在充气固定肺标本的HRCT扫描中显示。 (4 )病理大切片见 ,肺泡腔、支气管血管束管壁间隙内可见水肿液和红细胞 ;亚段肺不张。 (5 )常规病理见肺微血管扩张、破裂。肺泡隔、细支气管断裂。肺间质和肺泡腔内出血 ,并可见高蛋白、高渗出性水肿液。结论　高原颅脑枪弹伤远达效应肺损伤以血流扰动波所致的出血、渗出为主 ;损伤可诱发高原肺水肿 ;CT检查可发现出血渗出所致的实变、不张 ,以肺外带多见 ;HRCT可在早期发现肺小叶水平变化
[Abstract]:Objective to investigate the CT and HRCT findings and pathological basis of distant effect of craniocerebral gunshot wound at high altitude. Methods 18 pigs were divided into two groups: experimental group (n = 12) and control group (n = 6). The 5. 80 mm ballistic gun made in China caused penetrating injury to the right brain of pig. Chest CT and HRCT scans were performed to make inflatable fixed lung specimens, large pathological sections and routine pathological sections. The HRCTs of lung specimens were fixed by inflation, and the corresponding findings of pathological large sections and routine pathological sections were observed. Results (1) CT showed the consolidation of lobes, segments or subsegments, the edge of bronchovascular bundles was rough and blurred, and the surrounding lung fields showed glass-like changes, and atelectasis. (2) HRCT showed partial pulmonary lobule consolidation, emphysema, glass-like change, interlobular septum and lobular nucleus thickening and thickening. (3) the HRCT findings of living animals can be displayed in HRCT scans of inflatable fixed lung specimens. (4) Edema and erythrocyte could be seen in alveolar cavity, bronchial vascular bundle wall space, subsegmental atelectasis. (5) the pulmonary microvessel dilated and ruptured by routine pathology. Alveolar septum, bronchiole rupture. Interstitial and alveolar hemorrhage with high protein and highly exudative edema can be seen. Conclusion the distant effect of craniocerebral gunshot injury at high altitude is mainly caused by hemorrhage and exudation due to the disturbance wave of blood flow, and CT examination of high altitude pulmonary edema can find the consolidation and atelectasis caused by hemorrhage and exudation. HRCT can detect the changes of pulmonary lobules in the early stage.
【作者单位】：第四军医大学唐都医院放射科西藏军区总医院放射科西藏军区总医院放射科西藏军区总医院放射科第四军医大学唐都医院放射科西藏军区总医院放射科西藏军区总医院放射科西藏军区总医院放射科
【分类号】：R82

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