Fukuyama S, Aizawa H, Inoue H, Hidaka K, Murayama S, Murakami J, Hara N
Research Institute for Diseases of the Chest, Faculty of Medicine, Kyushu University.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Feb;35(2):245-9.
We report a case of intrapulmonary hematoma in which magnetic resonance imaging was useful in establishing the diagnosis. A 53-year-old man had bronchial asthma that was well controlled with inhaled beclomethasone dipropionate and salbutamol, and with oral theophylline. A spherical mass was found in the right lower lung field on a chest radiograph taken during a regular physical examination. A CT scan showed a well circumscribed spherical mass, which was attached to an intrapulmonary bullae. Magnetic resonance imaging showed a well-circumscribed mass in the superior segment of the right lower lobe. On a T1-weighted image the mass was hyperintense and had a higher-intensity rim. On a T2-weighted image the mass was hyperintense and had some hypointense areas. We therefore diagnosed intrapulmonary hematoma. Chest radiography 6 months later revealed a substantial decrease in the size of the mass, which supported the diagnosis. As in this case, intrapulmonary hematoma can be difficult to diagnose because of the lack of a history of injury and because of the slow regression. In this case, magnetic resonance imaging was useful in making the diagnosis.
我们报告一例肺内血肿病例,其中磁共振成像有助于确诊。一名53岁男性患有支气管哮喘,通过吸入丙酸倍氯米松和沙丁胺醇以及口服茶碱病情得到良好控制。在一次常规体检拍摄的胸部X光片上,右下肺野发现一个球形肿块。CT扫描显示一个边界清晰的球形肿块,附着于一个肺大疱。磁共振成像显示右下叶上段有一个边界清晰的肿块。在T1加权图像上,肿块呈高信号,边缘信号更高。在T2加权图像上,肿块呈高信号,并有一些低信号区域。因此我们诊断为肺内血肿。6个月后的胸部X光检查显示肿块大小显著减小,这支持了诊断。正如本例所示,由于缺乏受伤史且消退缓慢,肺内血肿可能难以诊断。在本例中,磁共振成像有助于做出诊断。