尿毒症维持性血液透析后胸部进展性病变的CT分析(1)
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[摘要]目的：分析长期尿毒症患者维持性血液透析后胸部进展性病变的CT表现及临床意义。方法：收集临床诊断尿毒症长期血透后胸部X线反复异常且进行性变化的46例患者的CT影像资料进行回顾性分析。结果：(1)肺部的CT表现多种多样：肺叶实变，肺组织毛玻璃密度，肺气囊或支气管扩张，肺内结节，弥漫性粟粒样密度，支气管血管间质增厚，肺气肿；(2)心脏大血管：心脏增大，心肌肥厚，肺静脉瘀血，肺动脉主干增粗，主动脉及冠状动脉血管壁钙化、心包钙化，心包脂肪垫增加；(3)胸腔积液或并叶间积液，胸膜增厚；(4)肺门、纵隔淋巴结轻、中度肿大；(5)胸壁椎体骨质增生前纵韧带钙化，肋骨病理骨折，小血管壁钙化，肌肉层萎缩脂肪层增厚。结论：尿毒症维持性长期血透后患者以心、肺病变为主，且胸部异常呈进行性、多样性CT影像改变。
[关键词]尿毒症；血液透析；计算机断层成像
[abstract]Objective：To discuss thoracic findings in long-term maintain Hemodialysis Patients based on the CT findings after X-ray and its clinical significance.Method:46 uremic patients with clinical complaints who had received long-term hemodialysis were retrospectively analyzed.lung,pleural,mediastinal,vascular,thoracic wall abnormalities related to hemodialysis therapy were assessed.Results:① various CTfindings of lung: vascular congestion, ground-glass opacity, parenchymalcarring-fibrosis,parenchymal consolidation,emphysema-bullae, broncho-vascular interstitial thickening, lung nodules, bronchiectasis;② Cardiovascularfindings: Aortic calcification, cardiomegaly, calcifications of the coronary arteries, pulmonary artery caliber enlargement;③ intrathoracic hilar and/or mediastinal lymphadenopathy enlargement was common CT findings in the hemodialysis patients; ④ pleural effusion,pleural thickening,fissural thickening;⑤thoracic wall soft-tissue calcification,costal fractures,muscular atrophy ......
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