- 期刊
- OpenAccess
Radiographic Evaluation of the Non-Traumatic Life-Threatening Hemothorax: Cases Report
非外傷引起致命性血胸的放射影像學評估：病例討論
摘要
許多疾病皆可引起血胸，但若是胸腔內大血管遭到侵襲及破壞時，大量血液便會流失進入肋膜腔中而引起致命性血胸。在七個不同原因造成致命性血胸的病例當中，普通的胸腔X光片只能發現大量的肋膜積水，合併有縱膈腔擴大，氣管移位及主動脈弓的消失，對其可能造成的原因則無法鑑別。然而電腦斷層掃瞄卻可以將造成血胸的原因詳細的刻劃出來，例如感染性動脈瘤(mycotic aneurysm)可見到有氣泡性的膿腫環繞著主動脈；主動脈剝離(aortic dissection)則可見到真假管腔及內膜瓣(intimal flap)，而主動脈瘤破裂(aortic aneurismal rupture)則可見到擴大的主動脈以及其不規則的管壁。除此之外，普通胸腔X光片無法區分血液及其他種類的液體，但電腦斷層掃瞄卻可以將具有稍高吸收值之血液給區分出來。 使用螺旋式及高速性電腦斷層掃瞄儀已大量的縮減檢查時間。我們認為使用胸部的電腦斷層掃瞄檢查對於非外傷性血胸是可靠的。
並列摘要
There are many diseases that may cause hemothorax, especially when the thoracic great vessels are destroyed and a large amount of blood leaks spontaneously creating life-threatening conditions. Seven cases are demonstrated to compare the effectiveness of the chest radiographs and CT images. Conventional radiographic features are confined to massive pleural effusion, widening of the mediastinum, deviation of the trachea and invisible aortic arch. However, CT depicts the actual causes of the hemothoraces as abscess formation surrounding the aorta in inycotic aneurysm, false and true lumens with an intimal flap in aortic dissection and dilatation of the aorta associated with irregularity of aortic wall in aneurysmal rupture. While blood couldn't be differentiated from other kinds of fluid by a chest radiograph it would be highly attenuated in CT and could easily be recognised. By using spiral or high-speed CT, the time and effort needed for the examination are reduced. It is also reliable to diagnose non-traumatic hemothorax by chest CT.