多层螺旋CT在肺撕裂伤中的表现及其应用价值
摘要
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审核发现，部分是抄袭博士或硕士，别人发表论文的长篇章节，表，图。格式不符合要求，研究方向，分类号不正确。表格不是三线表。前言太多，统计有误。讨论和前言及综述重复太多。近5年参考文献太少，英文文献太少。请修改。4月3日交医学院。 麻烦让抓紧修改，不要在敷衍我了，以前说好自己写的，可是这都是摘抄网上的。
背景 随着社会信息化和现代化的不断发展，医学技术的不断深入研究在社
会中的地位和作用也越来越重要。医学科技的数字化、可视化为临床信息的读取和存取提供了极大的便利性，同时，也显著提高信息读取、存取的效率和准确性。此外，随着中国人口的不断激增，各种交通意外事故的频发骇人听闻，所导致的严重后果如胸部创伤、头颅创伤等在医院急诊病例中亦非常常见。肺撕裂伤患者需要CT及时诊断并进行肺胸膜破裂口的修补，如果不够及时准确的判断，将严重危及患者的生命安全。探索多层螺旋CT在肺撕裂伤中的表现及其应用价值，旨在提高CT动态观察病情变化的准确认识，更好地完善医疗诊断技术，降低患者的死亡率。
目的 研究分析多层CT扫描技术应用于肺撕裂伤中的临床表现及其应用价值的探讨。
1.探讨高分辨计算机多体层的扫描(multi-slice spiral computed tomography, MSCT)图像在显示肺撕裂伤、气道及胸膜变化的问题上对肺组织观数据与临床诊断结合的分析。
2.深入总结多层螺旋CT技术的应用，使得临床上对于肺撕裂伤患者可获得形态学详细描述
3.通过比较多层螺旋CT技术与X线平片、MRI、CT等如今临床医学上常用的医学影像学手段之间的相同点和不同点，从而更加形象具体的探讨分析多层CT扫描技术应用于肺撕裂伤中的临床表现及其应用价值。
方法 选择2014年6月份我院收治的60例外伤患者为研究对象，均对其使用多层CT机进行胸部平扫，观察并记录所有患者的病变情况。然后1）对研究
患者CT处理数据进行分析，了解肺撕裂伤、气道及胸膜变化的问题上确立了主导地位，同时经过科学系统化的数据处理后，减少人为的主观干预，对患者不同程度肺撕裂伤进行定性定量的分析诊断。2）利用科学的表面遮盖显示(surface shaded display，SSD)技术对所有研究患者进行三维立体肺部（three-dimensional lung model，3D-lung)建模，并根据研究需要对其进行手工切除校正。3）讨论VRT作为立体图像的代表，能够进行任何方位的旋转观察同时与MIP技术的联合应用比较，效果更加直观清晰的展现出患者的状况，而MPR技术则是将对患者的病情的透射性结果，特别是当中的一些细节性的问题，使得对患者的诊断结果判定的可信度提高分析。
结果：1）CT表现：所有受测患者当中，共发现肺气肿患者15例，病灶35个，其中扁形病灶15个，圆形或椭圆形的病灶15个，囊肿壁厚薄不均匀的病灶3个，囊肿壁薄而均匀的病灶2个，囊肿壁周围都有片状的磨砂玻璃样阴影，气肿大小在3-28mm。其次在图像中可清晰的看出有一定程度的肺气液囊肿，在所有的患者CT图像观察中分析，肺气液囊肿患者共有25例，发现病灶部位65个，都可以明显的看出有气液平，且肺气液囊内的液体数量不等，其中呈弧形病灶30个，呈裂隙样病灶5个，表现成圆形或椭圆形的病灶30个。针对肺血肿患者的图像，患者中共有15例出现肺血肿现象，一共发现病灶15个，其形态表现主要为椭圆形，且血肿边界较清晰，大小在40-5-HU。其余的5例患者呈现蜂窝样改变，表现出低密度的蜂窝样阴影，内有许多小圆形的、裂隙样的气影，边界模糊不清。
结论：通过多层螺旋CT技术，可以清晰地观察到患者的肺部组织内的空腔的大小、分布、形态及其演变的变化规律，对于肺撕裂伤患者而言，诊断时快速有效，复查时，可以避免漏诊或误诊，安心放心。且多层螺旋CT在早期的诊断中，多层螺旋CT应用于临床检查或诊断，效果极具参考价值，值得推广使用。
【关键词】多层螺旋CT；肺撕裂伤；肺气囊肿；应用价值
Performance and application value of multi-slice spiral CT in pulmonary
laceration of [Abstract]
Objective To explore the research and analysis of multilayer CT scan technology in pulmonary laceration in the clinical manifestation and its application value. Discussion on high resolution computer multi body layer scanning (multi-slice spiral computed tomography, MSCT) analysis of the image in the display of pulmonary laceration, airway and pleural changes on the question of lung tissue and clinical diagnosis of leisure view data binding. Application and in-depth summary of multi-slice spiral CT technology, makes the patients with pulmonary laceration patients can obtain morphology described in detail, whether can be observed in patients with early secondary infection of lung surface, caused by pulmonary interstitial and pleural changes? Get detailed information on patients with early lung function status whether can quantitatively in clinical diagnosis?By comparing the same points between multi-slice spiral CT and X-ray plain film, MRI technology, CT is now commonly used clinical medicine medical imaging teaching means and different point, analysis and discussion of multislice CT scanning technology in the application of pulmonary laceration in the clinical manifestation and its value of application specific and thus more image, including the problems of its combination magazine reported at home and abroad were introduced, further complement the results of this study, to make the test results more persuasive.
Methods 60 cases of traumatic patients in our hospital from 2014 to June as the research object, on the use of multilayer CT chest scan, observe and record the lesions in all patients. Then 1) of study on CT in patients with treatment of data for analysis, understanding the laceration of the lung, airway and pleural change issue to establish a dominant position, at the same time, through scientific system of data processing, greatly reduced the effect of subjective human intervention on the patients with different degree, pulmonary laceration by qualitative and quantitative analysis method to diagnose better. 2) shaded display using scientific surface (surface shaded display, SSD) for three-dimensional lung for all study patients Technology (three-dimensional lung model, 3D-lung) modeling, and research needs to carry on the manual correction according to resection. Observation of the three-dimensional model, research, analysis.The combined application of processing technology of CT scanning
technology, including CPR, VRT, after MPR and MIP in the multi technology, describes the CPR technology can rib imaging bending in a plane to said, for patients suffered form does not obviously occult fracture shows more intuitive performance, discuss VRT as a representative of the stereo image, combination of rotating observation can be obtained at any range at the same time with MIP technology, the effect is more direct and clear to show the condition of patients, and the technique of MPR is to the patient's condition of transmission of the results, especially some details of the problem, make the patient's diagnosis results the determination of the reliability is improved analysis.
Results:
1) CT showed: in all the patients, were found in 15 cases of patients with emphysema, and 35 lesions, 15 lesions of the flat, round or oval lesions in 15, cyst wall of uneven thickness of 3 lesions, cyst wall is thin and uniform 2 lesions, cyst wall all around the shadow frosted glass like sheet, emphysema size in 3-28mm. Then in the image can be clearly seen with lung cysts to some extent, the analysis in the patients with CT were observed in all of the images in lung liquid cyst patients, a total of 25 cases, the lesions were found in 65, can be seen clearly with air fluid level, and the number of lung sac inside the liquid range, which is in the shape of an arc lesions 30, a slit like 5 lesions showed round or oval, 30 lesions. According to the image of pulmonary hematoma patients, patients with a total of 15 cases of pulmonary hematoma phenomenon, found a total of 15 lesions, the morphological manifestations were oval, and hematoma boundary is clear, size in 40-5-HU. The remaining 5 cases patients showed honeycombing, showed a honeycomb like shadow of low density, air in the shadow of many small round, slit like, blurred boundary.
2) the application value and significance: the application of multi-slice spiral CT technology, makes the patients with pulmonary laceration patients can obtain a detailed description of the external morphology, can be observed in patients with early secondary infection of lung surface, caused by pulmonary interstitial and pleural changes, get detailed information on patients with early pulmonary function can be quantitatively in clinical diagnosis the. Clinical observation of the patients with mild