【摘要】 目的分析原发性自发性气胸（PSP）MSCT胸部影像特征,探讨其形成机制。方法搜集PSP 45例及性别、年龄匹配胸部无明确病变（对照组）和继发性自发性气胸（SSP）患者各45例。测量前两组第六肋骨(6^th)倾斜度、气管分叉平面胸廓内径,观察肋骨内突（PRIL）、肺气肿样改变（BB）及气胸组胸膜孔情况。组间变量值和计量数差异分别采用t和χ²检验。结果 PSP组与对照组6^th倾斜度分别为:（54.5±16.8）°、（65.6±17.5）°（t=6.79,P<0.05）;10¹9岁、20²9岁和30³9岁气管分叉平面胸廓横径/前后径值分别为:2.65±1.24、2.58±1.02、2.61±1.12和2.04±0.74、2.08±0.87、2.05±0.78（t=4.28、4.05、4.39,P值均<0.05）;PRIL、BB检出例数分别为:25和10例（χ²=8.16,P<0.05）;35和4例（χ²=40.72,P<0.01）。PSP和SSP胸膜孔检出率分别为26.67%和6.67%（χ²=5.12,P<0.01）。结论胸廓扁平、PRIL、BB及胸膜孔为PSP特征影像,胸廓扁平增加跨肺压利于BB形成,PRIL增加胸膜压迫磨损,易致BB破裂或胸膜薄弱漏气形成PSP及胸膜孔。更多还原

【Abstract】 Objective To analyse the chest imaging features of primary spontaneous pneumothorax（ PSP） with multislice CT（ MSCT）,and discuss the mechanism of formation. Methods 45 cases of PSP confirmed by MSCT and thoracoscope were collected. In addition,every one of the 45 cases were matched for sex and agewith a group with chest without clear lesions（ control group） and the group with secondary spontaneous pneumothorax（ SSP） were randomly collected. The inclination of the sixth ribs( 6^th) 、thoracic inner diameter on the plane of tracheal bifurcation were measured and the prominent rib indentations on the lung surface（ PRIL） 、blebs and bullae（ BB） were observed in the first two groups and the state of the apex pulmonis pleural hole were observed in pneumothorax group. The values of the variables and the differences in measurements were respectively analysed using t and χ²test. Results Of PSP and control group,the inclination of the 6^th rib was:（ 54. 5 ± 16. 8） °、（ 65. 6 ± 17. 5） °（ t = 6. 79,P < 0. 05）; the ratio of width to diameter on thoracic tracheal bifurcation plane in 10 19y、20 29 y and 30 39 y was: 2. 65 ± 1. 24、2. 58 ± 1. 02、2. 61 ± 1. 12 and 2. 04 ± 0. 74、2. 08 ± 0. 87、2. 05 ± 0. 78（ t = 4. 28、4. 05、4. 39,P < 0. 05） respectively and with PRIL and BB were 25 and 10（ χ²= 8. 16,P < 0. 05）;35 and 4（ χ²= 40. 72,P < 0. 01）. The detection rate of apex pulmonis pleural hole in PSP and SSP was 26. 67% and6. 67%（ χ²= 5. 12,P < 0. 01）. Conclusion Flat chest、PRIL、BB and pulmonis pleural hole were the characteristic images of PSP; the first increased apex pulmonis transpulmonary pressure conducive to the formation of the BB,the second increased the pleural compression abrasion,lead to BB rupture or pleural weak leakage form PSP and apex pulmonis pleural hole; the latter maybe the result of PSP chest negative pressure.更多还原