Moore A D, Godwin J D, Dietrich P A, Verschakelen J A, Henderson W R
Department of Radiology, University of Washington, Seattle 98195.
AJR Am J Roentgenol. 1992 Jun;158(6):1211-5. doi: 10.2214/ajr.158.6.1590109.
To determine the importance of chest CT findings in patients with Swyer-James syndrome (unilateral small lung with air trapping) and to compare these findings with those on chest radiographs and scintigrams, we reviewed the CT scans, chest radiographs, and scintigrams of eight patients with the syndrome. Radiographs showed unilateral hyperlucency in seven patients and bilateral asymmetric hyperlucency in one. CT showed that the hyperlucency was unilateral in only three and that hyperlucency in one. CT showed that the hyperlucency was unilateral in only three and that hyperlucent regions on radiographs contained patches of normal lung attenuation in five patients. Conversely, in four patients, CT also showed small hyperlucencies in regions considered normal on radiographs. These lucencies usually had poorly defined margins and irregular shapes (five patients), but sometimes were peripheral, wedge shaped, and sharply demarcated (two patients). CT also showed subtle abnormalities not visible on radionuclide scans in two patients. Air trapping in hyperlucent regions was confirmed by a lack of change in volume on expiratory CT scans in five cases. Bronchiectasis was found in only three patients. CT helps to exclude central bronchial obstruction, cysts, and vascular disease as causes of hyperlucency. By excluding central obstruction, CT may make bronchoscopy unnecessary in some patients. CT is more sensitive than radiographs and radionuclide scans in detecting hyperlucent regions and in showing their distribution. Our experience suggests that bronchiectasis is not a necessary component of the Swyer-James syndrome.
为确定胸部CT表现对于Swyer-James综合征（单侧肺小且有空气潴留）患者的重要性，并将这些表现与胸部X线片和闪烁扫描的表现进行比较，我们回顾了8例该综合征患者的CT扫描、胸部X线片和闪烁扫描结果。X线片显示7例患者为单侧透亮，1例为双侧不对称透亮。CT显示仅3例为单侧透亮，1例X线片上的透亮区域包含5例正常肺实质衰减区。相反，4例患者CT还显示在X线片上看似正常的区域有小透亮区。这些透亮区边缘通常不清且形状不规则（5例），但有时位于周边、呈楔形且边界清晰（2例）。CT还显示2例患者有放射性核素扫描未显示的细微异常。5例患者呼气CT扫描上透亮区体积无变化证实了空气潴留。仅3例患者发现支气管扩张。CT有助于排除中央支气管阻塞、囊肿和血管疾病作为透亮的原因。通过排除中央阻塞，CT可能使一些患者无需进行支气管镜检查。CT在检测透亮区及其分布方面比X线片和放射性核素扫描更敏感。我们的经验表明支气管扩张并非Swyer-James综合征的必要组成部分。
