Im J G, Lee K S, Han M C, Kim S J, Kim I O
Department of Diagnostic Radiology, Seoul National University Hospital, Korea.
AJR Am J Roentgenol. 1991 Oct;157(4):697-701. doi: 10.2214/ajr.157.4.1892020.
The purpose of this study is to describe the radiologic manifestations of paraquat-induced pulmonary damage, with special emphasis on the sequential changes seen with this condition. Paraquat is a herbicide that has toxic effects on the lungs, liver, and kidneys. Progressive respiratory failure is a frequent cause of death. We analyzed retrospectively 42 patients with a history of paraquat ingestion and abnormal findings on chest radiographs. Radiographic changes during the first week after ingestion included diffuse consolidation (26/39), pneumomediastinum with or without pneumothorax (15/39), and cardiomegaly with widening of the superior mediastinum (8/39). Small cystic and linear shadows began to appear at the end of the first week and were the preponderant parenchymal abnormality after 2-4 weeks. Focal honeycombing was the major parenchymal abnormality after 4 weeks. High-resolution CT of the lung 9 months after paraquat exposure revealed localized fibrosis containing small cysts. Our study shows that the pulmonary manifestations of paraquat poisoning begin with air-space consolidation, which then leads to end-stage lung.
本研究的目的是描述百草枯所致肺损伤的影像学表现，特别强调该病症所呈现的一系列变化。百草枯是一种对肺、肝和肾有毒性作用的除草剂。进行性呼吸衰竭是常见的死亡原因。我们回顾性分析了42例有百草枯摄入史且胸部X线片有异常表现的患者。摄入后第一周的影像学变化包括弥漫性实变（26/39）、伴有或不伴有气胸的纵隔气肿（15/39）以及心脏增大伴上纵隔增宽（8/39）。小囊状和线状阴影在第一周结束时开始出现，2至4周后成为主要的实质异常。4周后，局灶性蜂窝状改变是主要的实质异常。百草枯暴露9个月后进行的肺部高分辨率CT显示局部纤维化伴小囊肿。我们的研究表明，百草枯中毒的肺部表现始于肺泡实变，随后发展为终末期肺。
