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目的 分析Swyer James综合征 (SJS)的CT表现 ,探讨其CT扫描和诊断价值。方法2 8例胸部CT扫描患者 ,均有深吸气状态下胸片 ,其中 5例有深呼气X线片 ,1例行支气管造影 ,2例经手术证实为闭塞性细支气管炎并支气管扩张。在常规深吸气后屏气螺旋CT扫描疑为SJS时 ,即进行深呼气后屏气状态下定位扫描和病变区螺旋扫描 ,观察病变肺叶容积变化和肺内气体潴留情况。结果 2 8例共累及 5 6叶肺 ,CT显示全部肺叶透亮度增高和肺野血管纹理细小 ,其中 5 1叶 (91% )容积缩小 ,5叶 (9% )容积正常 ;而胸片显示肺叶透亮度增高 2 9叶 (5 2 % )、其中容积缩小 19叶 (6 6 % ) ;深呼气CT扫描均发现受累肺叶不同程度的气体潴留 ,而 5例深呼气X线片仅发现 3例共 5叶有气体潴留 ;同时 ,CT显示合并支气管扩张 2 4例、肺结核 9例、细支气管炎 10例和节段性肺不张 2例 ,而胸片发现肺结核 6例 ,细支气管炎 4例。结论 深吸气和深呼气CT扫描是诊断和鉴别诊断SJS的最佳方法 ,明显优于胸片。
Objective To analyze the CT findings of Swyer James syndrome (SJS) and discuss the CT scan and its diagnostic value. Methods Twenty-eight patients with chest CT scan underwent chest X-ray with deep inspiration, including deep expiratory radiography in 5 cases, bronchography in 1 case, and bronchiectasis in 2 cases . In conventional deep inspiration breath-hold spiral CT scan suspected SJS, that is, deep breath after the breath-hold state scanning and lesion area spiral scan to observe changes in the lesion volume and pulmonary lung gas retention. Results Twenty-eight cases involving 56 lobes were observed. CT showed that all of the lobes were increased in lumpectomy and lungs were thinner. The volume of 5 1 leaves (91%) was reduced and the volume of 5 leaves (9%) was normal. The translucency increased by 29 leaves (52%), of which the volume decreased by 19 leaves (66%). The deep expiratory CT scan showed different degrees of gas retention in the affected lobes, while 5 cases of deep expiratory radiographs only found 3 A total of 5 leaves with gas retention; the same time, CT showed 24 cases of bronchiectasis combined, 9 cases of tuberculosis, 10 cases of bronchiolitis and segmental atelectasis in 2 cases, chest X-ray found in 6 cases, bronchiolitis 4 example. Conclusion Deep inspiration and deep breath CT scan is the best method to diagnose and differentiate SJS, which is obviously better than chest radiograph.