Fidler J L, Patz E F, Ravin C E
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
AJR Am J Roentgenol. 1993 Nov;161(5):937-42. doi: 10.2214/ajr.161.5.8273629.
Physiologic changes during pregnancy affect nearly every organ system. In the thorax, the diaphragm elevates as much as 4 cm because of displacement of the abdominal organs by the gravid uterus, resulting in lower lung volumes. Maternal blood volume and cardiac output increase approximately 45% by mid-pregnancy. Cardiac output can increase as much as 80% during vaginal delivery and up to 50% with cesarean section. These changes result in pulmonary vascular engorgement, progressive left ventricular dilatation, and mild hypertrophy (Fig. 1). Pregnant patients are also prone to a number of pulmonary insults, including infection, aspiration, and neoplastic disease. These abnormalities have several radiographic patterns: cardiogenic and noncardiogenic pulmonary edema, focal pulmonary abnormalities, and extraalveolar air. Radiologists must recognize not only the normal chest radiographic appearance in these patients but also the thoracic complications associated with pregnancy.
孕期的生理变化几乎会影响每个器官系统。在胸部，由于妊娠子宫使腹部脏器移位，膈肌抬高多达4厘米，导致肺容积减小。到妊娠中期，孕妇血容量和心输出量增加约45%。阴道分娩时心输出量可增加多达80%，剖宫产时则高达50%。这些变化导致肺血管充血、左心室逐渐扩张和轻度肥厚（图1）。孕妇还容易受到多种肺部损伤，包括感染、误吸和肿瘤性疾病。这些异常有几种影像学表现：心源性和非心源性肺水肿、局灶性肺部异常和肺泡外气体。放射科医生不仅必须认识到这些患者胸部X线片的正常表现，还必须认识到与妊娠相关的胸部并发症。
