Levesque Marie-Helene, Montesi Sydney B, Sharma Amita
*Department of Radiology, Thoracic Imaging Division †Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, MA.
J Thorac Imaging. 2015 Jul;30(4):220-32. doi: 10.1097/RTI.0000000000000133.
Acute dyspnea is a common presenting complaint in the Emergency Room. Evaluation with chest radiography is vital for initial assessment and may reveal diffuse parenchymal abnormalities that require further assessment with computed tomography (CT). The aim of this review is to outline a pattern-based approach for the analysis of diffuse pulmonary abnormalities in an acutely dyspneic patient with emphasis on CT appearances. Specific disease entities may be differentiated by their distribution in the lungs and by their radiologic findings. Recognition of the predominant finding and its distribution can generate an appropriate differential diagnosis that is further refined by the presence or absence of ancillary findings. Incorporation of the clinical history, laboratory data, and prior studies narrows the differential diagnosis, indicates the optimum modality for further evaluation, and, in some situations, provides important prognostic data.
急性呼吸困难是急诊室常见的就诊主诉。胸部X线检查对于初始评估至关重要，可能会发现需要通过计算机断层扫描（CT）进一步评估的弥漫性实质异常。本综述的目的是概述一种基于模式的方法，用于分析急性呼吸困难患者的弥漫性肺部异常，重点是CT表现。特定疾病实体可通过其在肺部的分布及其影像学表现来鉴别。识别主要表现及其分布可产生适当的鉴别诊断，并通过有无辅助表现进一步细化。结合临床病史、实验室数据和既往研究可缩小鉴别诊断范围，指明进一步评估的最佳方式，并且在某些情况下提供重要的预后数据。
