Verma Nupur, Hochhegger Bruno, Mukhopadhyay Sanjay, Teixeira E Silva Torres Pedro Paulo, Mohammed Tan-Lucien
Department of Radiology, University of Massachusetts - Baystate, Springfield, MA.
Department of Radiology, University of Florida, Gainesville, FL.
J Thorac Imaging. 2025 May 1;40(3):e0820. doi: 10.1097/RTI.0000000000000820.
Acute lung injury (ALI) is acute pulmonary inflammation with underlying pathology of disruption of the pulmonary vasculature endothelial and alveolar epithelial barriers. ALI is not an uncommon diagnosis and has a myriad of causes including pulmonary infection, (including sepsis), drugs, connective tissue disease, and polytrauma. Patients present clinically with hypoxemia with imaging supportive of bilateral pulmonary findings without pulmonary edema. The imaging findings in ALI mirror pathologic changes, with a transition from an early ("exudative") phase to a later fibroblast-rich ("organizing" or "proliferative") phase to, in some cases, a fibrotic phase. The diagnosis of ALI is separate from, but can clinically overlap in presentation with, acute respiratory distress syndrome and is characterized by diffuse alveolar damage and organizing pneumonia patterns on pathology. Clinical management is most often supportive and can include corticosteroids, mechanical ventilation, and careful fluid management, with the goal of preserving and recovering lung function.
急性肺损伤（ALI）是一种急性肺部炎症，其潜在病理表现为肺血管内皮和肺泡上皮屏障的破坏。ALI并非罕见的诊断，其病因众多，包括肺部感染（包括脓毒症）、药物、结缔组织病和多发伤。患者临床上表现为低氧血症，影像学显示双侧肺部病变但无肺水肿。ALI的影像学表现反映了病理变化，从早期（“渗出性”）阶段过渡到后期富含成纤维细胞的（“机化性”或“增殖性”）阶段，在某些情况下会发展为纤维化阶段。ALI的诊断与急性呼吸窘迫综合征不同，但在临床表现上可能重叠，其病理特征为弥漫性肺泡损伤和机化性肺炎模式。临床管理通常以支持治疗为主，可包括使用皮质类固醇、机械通气和谨慎的液体管理，目标是保护和恢复肺功能。
