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目的 探讨CT对百草枯中毒肺损伤的诊断价值和影像学特征。方法 回顾性分析22例百草枯中毒患者胸部的影像学资料。评估CT对百草枯中毒肺损伤的诊断价值,分析影像学特点。结果 22例百草枯中毒患者中14例存活3周以上,8例于2周内死亡,以此将病例分成2组。第1组,较规律观察组,按时间分成中毒早期(2d以内)、中期(3～14d),中后期(14d以上)。早期CT表现以肺通气过度、毛玻璃密度为相对特征,占57.1％(8/14)。中期以广泛毛玻璃密度、肺间质改变、肺实性变和渗出性病变为主,占92.9％(13/14)。晚期病变呈迁延改变,转归决定影像特征。肺渗出实变、肺纤维化仍为主要影像征表现。第2组,以肺实变和渗出为主要表现,并提示预后差。CT检查具有病变发现早、提供影像信息多、表现相对特异的优势。结论 CT检查对百草枯中毒肺损伤的发现和进展分析具有明显优势,影像表现具有一定的特征性,对指导临床治疗具有重要意义。
Objective To investigate the diagnostic value and imaging features of CT on paraquat-induced lung injury. Methods The chest imaging data of 22 paraquat poisoning patients were retrospectively analyzed. To evaluate the diagnostic value of CT on paraquat-induced lung injury and analyze the imaging features. Results Of the 22 patients with paraquat poisoning, 14 patients survived for more than 3 weeks and 8 patients died within 2 weeks. The cases were divided into two groups. Group 1, compared with regular observation group, were divided into time poisoning early (within 2d), medium (3 ~ 14d), the late (more than 14d). Early CT manifestations of pulmonary hyperventilation, frosted glass density is the relative characteristics, accounting for 57.1% (8/14). In the mid-term, the gross gross glass density, interstitial lung mass changes, solid and exudative lung lesions were the major components, accounting for 92.9% (13/14). Late lesions showed persistent changes, prognosis to determine the image characteristics. Pulmonary exudate consolidation, pulmonary fibrosis is still the main imaging signs. Group 2, the main manifestation of pulmonary consolidation and exudation, and prompted the poor prognosis. CT examination with lesions found early to provide more image information, the performance of relatively specific advantages. Conclusion CT examination of paraquat poisoning lung injury found in the analysis and progress has obvious advantages, the imaging performance has certain characteristics, to guide the clinical treatment of great significance.