Arrivé L, Tasu J P, Kitzis M, Lesêche G, Najmark D, Duchatelle J P, Nahum H
Department of Radiology, Hôpital Beaujon, Clichy, France.
Radiology. 1994 Jul;192(1):177-81. doi: 10.1148/radiology.192.1.8208933.
To demonstrate the computed tomographic (CT) appearance of the postpneumonectomy space (PPS) after surgical treatment of postpneumonectomy empyema.
The authors retrospectively reviewed 22 CT scans obtained in 15 patients after open window thoracostomy (OWT) (n = 4), myoplasty (n = 12), and epiploplasty (n = 1).
After uncomplicated OWT, the retracted PPS contained air and/or gauze without residual pleural fluid. After uncomplicated myoplasty, marked retraction of the operated hemithorax was observed. CT allowed localization of transposed muscle flaps and fatty tissue within the PPS. A moderate amount of fluid and air was present during the 1st month after surgery. After uncomplicated epiploplasty, the retracted PPS contained homogeneous tissue with characteristic fatty attenuation. Complications including recurrent empyema, recurrent bronchopleural fistula, aseptic fluid collection, necrosis and fatty transformation of muscle flaps, and tumor recurrence were accurately demonstrated.
CT is useful in follow-up after surgical treatment of postpneumonectomy empyema because it permits accurate evaluation of the PPS.
展示肺叶切除术后脓胸手术治疗后肺叶切除后间隙（PPS）的计算机断层扫描（CT）表现。
作者回顾性分析了15例患者术后获得的22份CT扫描图像，这些患者分别接受了开窗胸廓造口术（OWT）（4例）、肌成形术（12例）和网膜成形术（1例）。
在未发生并发症的OWT后，回缩的PPS内含有空气和/或纱布，无残留胸腔积液。在未发生并发症的肌成形术后，观察到手术侧半胸明显回缩。CT可定位PPS内移位的肌瓣和脂肪组织。术后第1个月内存在适量的液体和空气。在未发生并发症的网膜成形术后，回缩的PPS内含有具有特征性脂肪衰减的均匀组织。准确显示了包括复发性脓胸、复发性支气管胸膜瘘、无菌性积液、肌瓣坏死和脂肪变性以及肿瘤复发等并发症。
CT在肺叶切除术后脓胸手术治疗后的随访中有用，因为它能准确评估PPS。
