33例自发性纵隔气肿：胸部计算机断层扫描对轻型诊断的价值
Spontaneous pneumomediastinum in 33 patients: yield of chest computed tomography for the diagnosis of the mild type.
作者信息
Kaneki T, Kubo K, Kawashima A, Koizumi T, Sekiguchi M, Sone S
机构信息
Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
出版信息
Respiration. 2000;67(4):408-11. doi: 10.1159/000029539.
BACKGROUND
Spontaneous pneumomediastinum (SPM) usually occurs in young people without an apparent precipitating factor or disease. Although there have been many studies focused on the clinical features and standard chest X-ray (CXR) findings of SPM, few have reviewed the chest computed-tomographic (CT) findings.
OBJECTIVES
We assessed SPM using CXR and CT, and the relation between them.
METHODS
We evaluated 33 patients (26 males) diagnosed with SPM on the basis of symptoms and chest radiological findings.
RESULTS
Three patients showed normal CXR but a diagnostic CT scan. Seven showed mild pneumomediastinum on CXR. In these 10 patients, pneumomediastinum was easily detected by chest CT. Moderate and severe SPM were easily detected by both CXR and CT.
CONCLUSIONS
These findings suggested that CXR alone poorly detected approximately 30% of SPM and that chest CT scan was needed to make the diagnosis in these cases. It seems likely that SPM is underdiagnosed by 30% or more in clinical practice.
背景
自发性纵隔气肿（SPM）通常发生在无明显诱发因素或疾病的年轻人中。尽管已有许多研究聚焦于SPM的临床特征和标准胸部X线（CXR）表现，但很少有研究对胸部计算机断层扫描（CT）表现进行综述。
目的
我们使用CXR和CT评估SPM及其两者之间的关系。
方法
我们根据症状和胸部影像学表现对33例（26例男性）诊断为SPM的患者进行了评估。
结果
3例患者CXR正常但CT扫描可诊断。7例CXR显示轻度纵隔气肿。在这10例患者中，胸部CT很容易检测到纵隔气肿。中度和重度SPM通过CXR和CT都很容易检测到。
结论
这些发现表明，仅CXR对约30%的SPM检测效果不佳，在这些病例中需要进行胸部CT扫描以做出诊断。在临床实践中，SPM漏诊率似乎可能达到30%或更高。
Zotero 插件