【摘要】 目的 探讨支气管粘液嵌塞的放射学表现，以求提高对此征象的认识和诊断水平。方法 28例患者均行标准后前位高千伏胸片，其中14例行胸部CT扫描，3例还行高分辨率CT(HRCT)扫描。22例患者有咯出粘液栓病史；5例肺癌合并支气管粘液嵌塞经手术病理证实；1例患者经支气管镜取出粘液栓。结果 X线平片显示支气管粘液栓大多为树枝状(18/28)，亦可表现为圆形、棒状或墨斗鱼状(18/28)，1例只表现为肺不张。CT所见支气管粘液嵌塞同样多数也为树枝状(9/14)，其余为小棒状(5/14)和葡萄状(3/14)。无论是在X线平片上还是在CT片上，支气管粘液栓的显著特点是主轴指向肺门，且与支气管走向分布一致，伴有支气管扩张。结论 X线平片并结合CT扫描是发现和诊断支气管粘液嵌塞的良好方法。只要掌握支气管粘液嵌塞的基本特点和放射学表现，将会提高诊断水平。

    Radiological study of bronchial mucoid impaction

YU Xiaoyi^* , YAN Hongzhen, WANG Tongde, et al. *Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730

【Abstract】 Objective To evaluate the radiological findings of bronchial mucoid impaction in 28 patients in order to improve diagnostic efficacy. Methods Standard posteroanterior high voltage radiographs were performed in all 28 cases. Among them CT scans were taken in 14 cases, while 3 patients underwent HRCT examination at the same time. Twenty-two patients had a history of expectoration of mucous plugs; in one case with pulmonary atelectasis, a mucous plug was picked out through bronchoscopy. The other 5 cases experienced a lung operation, and a tumor and bronchial mucoid impaction were discovered. Results Radiographs showed most mucoid impaction as thick, branching structures resembling branches of tree; others were in the shapes of spherical, small clubs, and cuttle fish. In one patient, pulmonary atelectasis was the only radiographic finding. Similarly on CT, most bronchial mucoid impaction were likened to tree branches; the rest presented as small clubs and bunches of grape. A prominent feature of bronchial mucoid impaction, either on plain radiograph or on CT, was that its axis pointed to the hilum, completely consistent with the branching and distribution of the bronchi, and accompanied by brochiectasis. Conclusions It is an optimal approach to exploit plain radiograph combined with CT to find out bronchial mucoid impaction. An awareness of its clinical and radiological features may improve better understanding and recognition of the disease.

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