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目的:探讨高原肺水肿(HAPE)CT影像特征及其 病理基础.方法:32例HAPE,35例小叶性肺炎患者纳入观 察.采用胸部常规与薄层CT扫描,连续观察病程各期征象表 现及变化.收集经尸检证实HAPE肺组织标本6例.肺门水平 冠状切开全肺,在内中外三带、上中下三野连续取材,观察与 CT相对应结构的病理变化.结果:①32例HAPE中28例右 肺病变重于左肺,35例小叶性肺炎仅有14例(P<0.01); ②HAPE早期(32/32)和恢复期(25/32)以肺间质异常表现为 主.进展期(30/32)与稳定期(32/32)以肺实质病变为主; ③病程中肺实质表现从磨玻璃样变逐渐过渡到结节样实变 再到结节融合呈大片实变;④病理检查见肺泡腔充满水肿液 及数量不等的纤维素、红细胞、炎细胞.肺泡隔增宽,小血管扩 张淤血.3例见纤维蛋白透明血栓,4例有肺透明膜形成,5例 有灶性或片状出血.结论:CT检查可发现HAPE早期病例,准
Objective: To investigate the characteristics and pathological basis of high resolution pulmonary edema (HAPE) CT images.Methods: Thirty-two HAPE patients and 35 patients with lobular pneumonia were enrolled in this study.Using routine thoracic and TLC CT scans, .The HAPE specimens were collected from 6 patients with HAPE confirmed by autopsy.All patients were divided into three groups: 28 cases of right lung disease were heavier than the left lung, 35 cases of lobular pneumonia were only 14 cases (P <0.01); ② early (32/32) and recovery (25/32) (30/32) and stable period (32/32) were predominantly pulmonary parenchymal lesions. ③ During the course of disease, pulmonary parenchymal manifestations gradually changed from ground-glass-like to nodal-like to nodular fusion, ④ pathological examination see the alveolar cavity full of water Fluid and varying amounts of cellulose, erythrocytes, inflammatory cells, alveolar septum widening, small blood vessels dilatation and congestion .3 cases see fibrinous transparent thrombus, 4 cases of lung transparent membrane formation, 5 cases of focal or flake bleeding. Conclusion: CT examination can be found early HAPE cases, prospective