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目的研究并分析急慢性心源性肺水肿患者的肺部X线与CT影像学表现,进而提升心源性肺水肿患者诊断的准确率。方法 100例发病24 h内心源性肺水肿患者分别行X线与CT检查。结果慢性心源性肺水肿主要表现为间质性肺水肿,在肺部X线和CT影像学下都表现为肺野透光度降低,小叶间隔线增厚如克氏线、胸膜下线出现和肺实质膜玻璃样变等间质性肺水肿改变,肺血重新分布,肺纹理增重、增多等现象,比较征象检查率结果显示肺部CT的征象分辨率高于X光的征象分辨率,二者的差异具有统计学意义(P<0.05)。急性心源性肺水肿则主要表现为肺泡性水肿,在X线与CT影像学下均表现为腺泡斑片状、结节以及大片融合影。空气支气管像,病变边缘模糊的现象也时而可见。病变进展时除少数典型者出现“蝶翼征”现象,大多数均为双肺出现广泛的密度均匀实变阴影。二者在病变征象检出率方面结果接近,比较差异无统计学意义(P>0.05)。结论慢性心源性肺水肿通过肺部CT检查的征象检出率较高,能更清晰地反映出更多诊断信息,从而提高临床诊断率;而急性心源性肺水肿通过对肺部进行X线与CT征象表现相似,临床诊断率相当,无特别区分意义。
Objective To study and analyze the pulmonary X-ray and CT imaging findings in patients with acute and chronic cardiogenic pulmonary edema to improve the diagnostic accuracy of patients with cardiogenic pulmonary edema. Methods 100 cases of patients with cardiogenic pulmonary edema within 24 hours after onset of X-ray and CT examination. Results Chronic cardiogenic pulmonary edema mainly manifested as interstitial pulmonary edema, lung lung transmissivity decreased in lung X-ray and CT imaging, thickening of interlobular septal line such as Kirschner wire, subpleural line appeared And interstitial pulmonary parenchyma of the plasma membrane interstitial pulmonary edema changes, red blood lung distribution, increased lung markings and other phenomena, compared with signs of examination results showed that the signs of lung CT resolution higher than the X-ray imaging resolution , The difference between the two was statistically significant (P <0.05). Acute cardiogenic pulmonary edema is mainly manifested as alveolar edema, X-ray and CT images showed acne patchy, nodules and large fusion. Air bronchoscopy, blurred edge of the disease is also visible from time to time. In addition to a small number of lesions in the development of typical “butterfly sign” phenomenon, most of the lungs are uniform density of a wide range of solid shadow. The two in the lesion detection rate of the results are similar, the difference was not statistically significant (P> 0.05). Conclusions Chronic cardiogenic pulmonary edema has a higher detection rate of CT through lung CT, which can more clearly reflect more diagnostic information and improve the clinical diagnosis rate. However, acute cardiogenic pulmonary edema Line and CT signs of similar performance, the clinical diagnosis rate is quite significant, no special distinction.