Choe Du Hwan, Lee Byung Hee, Kim Kie Hwan, Baek Hee Jong, Park Jong Ho, Lee Jae Cheol
Department of Radiology, Korea Cancer Center Hospital, 215-4 Gongneung-Dong, Nowon-Gu, Seoul 139-706, South Korea.
Clin Imaging. 2006 May-Jun;30(3):173-6. doi: 10.1016/j.clinimag.2005.11.003.
The purpose of this study was to assess and characterize the computed tomographic (CT) findings of various volume-expanding complications occurring in the postpneumonectomy space. Chest CT scans, obtained in 17 patients in whom plain chest radiographs had revealed shift of the mediastinum away from the surgical side after pneumonectomy for lung cancer, were retrospectively reviewed. Recurrent neoplasm (n=6) appeared as soft-tissue mass projecting into the postpneumonectomy space and/or enlarged mediastinal lymph nodes. Empyema (n=4) was manifested by smooth thickening of the residual pleura with or without thickening of the extrapleural tissues. Hemothorax (n=4) was characterized by amorphous material of high attenuation contained within the postpneumonectomy space. Chylothorax (n=2) presented no abnormal finding except for expansion of the postpneumonectomy space. The remaining one case showed only expansion of the postpneumonectomy space and it was normalized without any treatment, which was supposed to be transient pleural fluid collection of uncertain cause. When mediastinal shift away from the surgical side occurs on plain chest radiography following pneumonectomy, CT can be helpful in differentiating various volume-expanding complications providing characteristic features.
本研究的目的是评估和描述肺叶切除术后胸腔内各种容积增加性并发症的计算机断层扫描（CT）表现。回顾性分析了17例肺癌肺叶切除术后胸部X线平片显示纵隔向手术侧移位患者的胸部CT扫描结果。复发性肿瘤（n = 6）表现为突入肺叶切除术后胸腔和/或纵隔淋巴结肿大的软组织肿块。脓胸（n = 4）表现为残余胸膜光滑增厚，伴或不伴有胸膜外组织增厚。血胸（n = 4）的特征是肺叶切除术后胸腔内有高密度无定形物质。乳糜胸（n = 2）除肺叶切除术后胸腔扩大外无异常发现。其余1例仅表现为肺叶切除术后胸腔扩大，未经任何治疗即恢复正常，推测为原因不明的短暂性胸腔积液。肺叶切除术后胸部X线平片显示纵隔向手术侧移位时，CT有助于鉴别具有特征性表现的各种容积增加性并发症。
