Liu Zhen-juan, Huang De-jian, Wang Zhong-qiu, Wang Zheng-ge, Chang Shuang-hui, Wu Zheng-can
Department of Medical Imaging, Clinical College of Medical School, Nanjing University, Nanjing General Hospital of Nanjing PLA Military Command, Nanjing 210002, China.
Zhonghua Yi Xue Za Zhi. 2010 Oct 26;90(39):2740-4.
To investigate the radiographic and computerized tomographic features of chest in patients with acute chlorine poisoning and its diagnostic value.
Twenty-eight cases of chlorine poisoning were reviewed. And their radiographic and computerized tomographic features were compared and analyzed.
Radiographic findings: among 28 patients, 9 cases were normal and 2 cases had no abnormalities on the first chest X-ray and became abnormal one or two days later. And there were abnormal findings in first chest X-ray in 17 patients:acute tracheal inflammation of peribronchitis (n = 3), acute chemical bronchopneumonia (n = 6) and diffuse interstitial and central pulmonary edema (n = 8). CT manifestations: At Days 1-3, the patients of mild poisoning had scattered patchy dense shadow; those of moderate to severe poisoning showed multiple patchy or diffuse infiltration (ground-glass opacity). And partial consolidation, air bronchogram and pleural effusion could be observed. At Days 4-10, the manifestations of mild poisoning were largely absorbed; those of moderate to severe poisoning manifested the absorption of diffuse or multiple patchy effusion and a fading of shadow. And the size of lung consolidation became smaller than before. At Day 10 after onset, 4 patients completely recovered. At Days 30-40, 6 cases showed traces of fibrous shadow and one case showed small punctiform opacities in both lungs. And at Day 42, there was slight ground-glass change.
Acute chlorine gas poisoning in varying degrees may manifest acute bronchial pneumonia and acute pulmonary edema. During treatment, a series of chest X-ray examinations will help to follow the changes of disease. And CT examination can offer a more accurate evaluation of lung lesions.
探讨急性氯气中毒患者胸部X线及CT表现及其诊断价值。
回顾性分析28例氯气中毒患者，对其胸部X线及CT表现进行对比分析。
胸部X线表现：28例患者中，9例首次胸部X线检查正常，2例首次胸部X线检查无异常，12 d后出现异常。17例首次胸部X线检查有异常表现：急性气管支气管炎（3例）、急性化学性支气管肺炎（6例）、弥漫性间质性和中央性肺水肿（8例）。CT表现：13 d，轻度中毒患者表现为散在斑片状致密影；中重度中毒患者表现为多发斑片状或弥漫性浸润影（磨玻璃影），可见部分实变、空气支气管征及胸腔积液。410 d，轻度中毒患者表现大部分吸收；中重度中毒患者表现为弥漫性或多发斑片状渗出吸收，阴影变淡，肺部实变范围较前缩小。发病10 d后，4例患者完全恢复。3040 d，6例可见纤维条索影，1例双肺可见小斑片状致密影。42 d可见轻度磨玻璃样改变。
急性氯气中毒可出现不同程度的急性支气管肺炎及急性肺水肿。治疗过程中，系列胸部X线检查有助于观察病情变化，CT检查可更准确地评估肺部病变。
