肺血管CT成像技术在急性呼吸窘迫综合征中的运用：现状与展望

Application of pulmonary vascular CT imaging in acute respiratory distress syndrome: current status and prospects

摘要:

急性呼吸窘迫综合征（acute respiratory distress syndrome，ARDS）是一种以肺毛细血管内皮细胞及肺泡上皮细胞损伤而形成的顽固性低氧血症的疾病。肺CT在ARDS的诊断和评估中起重要作用，而肺CT血管成像技术在慢性阻塞性肺疾病、肺栓塞、肺动脉高压的诊治中起主要作用，对于ARDS中肺部灌注、肺血管改变关注相对较少。本综述通过对肺部CT血管成像在各疾病中的运用状况，肺血管CT成像研究最新进展，结合ARDS的发生机制及病理生理改变，简述肺血管CT成像在ARDS的运用现状及应用影像学改变评估ARDS的展望。

Abstract:

Acute respiratory distress syndrome（ARDS） is an intractable hypoxemia caused by injury of pulmonary capillary endothe－lial cells and alveolar epithelial cells. Pulmonary computed tomography（CT） plays an important role in the diagnosis and evaluation of ARDS，whereas pulmonary CT angiography plays an important role in the diagnosis and treatment of chronic obstructive pulmonary disease，pulmonary embolism，and pulmonary hypertension. However，the use of pulmonary CT angiography in the evaluation of lung perfusion and vascular changes during ARDS has rarely been examined. This article reviews the application of pulmonary CT angiog－raphy in pulmonary diseases，the latest progress in pulmonary vascular CT imaging，and the pathogenesis and pathophysiological changes of ARDS. We will briefly discuss the current application of pulmonary vascular CT imaging in ARDS and the feasibility of using imaging changes to evaluate ARDS.