放射科经常报胸膜增厚、粘连,那在CT上,什么是胸膜粘连、胸膜增厚呢?
胸膜不粘连,怎么形成包裹性胸腔积液?
什么是胸膜增厚?
什么是肋间隙狭窄?
CT怎么看贫血?
请看经典图谱!
正常的胸膜非常的薄,薄如蝉翼,在CT上是look不到的!
你能看到的胸膜,几乎都是增厚的!
像堆石头、挤公交车、挤地铁、春运火车、看演唱会等造型的,就是肋间隙明显狭窄!
血液密度明显低于室间隔,或者血液密度明显低于血管壁的情况下,提示贫血!
随便瞅一眼,室间隔显而易见,血液暗黑风格,提示贫血!
有人做过研究:The larger the extent of the residual pleural thickness after antituberculous medication, the greater the reduction in the FVC, FIVC, TLC. A pleural thickness of 3 mm is recommended as a guideline for diagnosing a restrictive pulmonary dysfunction.
意思就是:抗结核药物治疗后胸膜残留厚度越大,FVC、FIVC(用力吸气肺活量)、TLC(肺总量)下降越大。胸膜厚度3毫米被推荐作为诊断限制性肺功能不全的指标。
参考文献:Lee, Young Kyoung, Na, Moon Jun, Yun, Bo Ra,等. The Effect of the Extents of Pleural Thickening in Tuberculous Pleurisy on the Impairment of Pulmonary Function[J]. 2001.
国内有人做过研究:Intrathoracic hyaluronate-based gel (HAbg) can prevent pleural thickening and improve lung function in patients who have a large amount of tuberculous pleural effusions (TPE).
意思就是:胸腔内注射透明质酸可以预防大量结核性胸腔积液所导致的胸膜增厚,改善肺功能。
这么多年过去了,指南有说透明质酸吗?预防胸膜增厚,征途遥远!
参考文献:Zhou A , Guo L , Tang L . Effect of an intrathoracic injection of sodium hyaluronic acid on the prevention of pleural thickening in excess fluid of tuberculous thoracic cavity[J]. Clinical & Experimental Pharmacology & Physiology, 2010, 30(3):203-205.
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肺不张、包裹性胸腔积液
这个反转,我没想到!
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