B超应用论文 （二十六）.docVIP

80例放射性肺炎的CT表现及分析 作者：章斌　庄小勇　　 【摘要】 目的　为提高对早期放射性肺炎的诊断。　方法　回顾性观察分析经治疗和临床随访证实为放射性肺炎的80例患者（男性52例，女性28例，年龄最小35岁，最大76岁）的CT影像资料。　结果　放射性肺炎急性期表现为边界清晰或不清晰的实变影，内可见支气管充气征。慢性期表现为边界清晰的条索状阴影并可交织成网状，伴有肺气肿及横膈升高、纵隔移位以及胸廓塌陷畸形等。　结论　放射性肺炎病变绝大多数限于放射治疗野内，病变区及外周肺血管缩小或减少，急性期为渗出病灶为主，慢性期为纤维病灶为主，发生的严重程度与肺受照射面积和总剂量有关。应与肺癌放疗后复发、获得性肺炎和肺不张鉴别。 【关键词】 放射性肺炎； 体层摄影术，X线计算机； 诊断 CT finding of radiation pneumonitis in 80 cases and analysis ZHANG Bin，ZHUANG Xiao-yong Department of Radiology，Didactical base of Fujian Medical College ,the second hospital of Fujian Sanming 366000, China 【Ａｂｓｔｒａｃｔ】 Objective To improve early diagnosis of radiation pneumonitis. Methods CT imaging data of 80 patients（52 male and 28 famale，age ranging from 35 to 76）were observed and analysed retrospectively. Results The CT finding of radiation pneumonitis showed which had a clear or blurry boundary and Air bronchogram during the acute period, and it showed fibrotic focus with a clear boundary during the chronic period with emphysema and rise the diaphram, mediastinal shift and theracic collapse, and other deformities. Conclusion The pathological area mostly locates within the radiotheraphy field,and the damage depends on the irradiation area and total absorbed dose. CT finding shows transudatory focus mostly appear in the acute period, and fibrotic focus mostly appear in the chronic period. Shrink and decrease of the pathological area veins and the exterior lung veins can be observed. It is important to distinguish radiation pneumonitis from recrudescence of lung cancer after radiotherapy, pneumonia and atelectasis. 【Ｋｅｙ ｗｏｒｄｓ】 Radiation pneumonitis，Tomography,X ray-computed, Diagnose 由于对肺癌、乳腺癌、食管癌、恶性淋巴瘤或其他纵隔、胸壁的恶性肿瘤患者进行大面积、大剂量放射治疗后引起患者的肺组织损伤，出现肺的急性反应性渗出变性而致慢性纤维化的病变过程称为放射性肺炎[1]。其临床表现变化大，轻症者可无症状，重症者因广泛的肺纤维化病变而致呼吸功能障碍甚至死亡。它是放射治疗中常见并发症之一。放射性肺炎实际上是一种无感染性的炎症，它是不可逆的，对它的预防比治疗更为重要。因此要对放射治疗的患者定期做X线影像学检查，尽早发现放射性肺炎，特别在伴有慢性支气管炎、肺气肿、肺结核、支气管扩张、矽肺或结缔组织疾病时，放射性肺炎一经诊断就应立即停止放射治疗，进行有效的处理。这就要求影像科医生提高对放射性肺炎的认识和诊断准确性，尽可能早期发现放射性肺炎