Decreased lung markings

Introduction The change of lung texture is affected by many factors. Any structure that forms the lung pattern changes, which leads to lung changes. The lung pattern is rare due to excessive expansion of lung volume such as emphysema. Congenital heart disease and lungs with less blood. The pattern is also rare. The reduction in lung texture in most cases means a reduction or thinning of the pulmonary blood vessels, the so-called "pulmonary ischemic sign".

Cause

Common in congenital heart disease or emphysema. Lung texture reduction, also seen in one side, such as one side obstructive emphysema, giant pulmonary bullae, unilateral pulmonary embolism, one leaf or a section of lung tissue over-expansion, compression of normal lung tissue, mediastinal organs and cardiovascular system, is One of the common causes of acute respiratory distress in infants and young children. Only found in newborns or young children, 1/3 of the cases immediately after birth, 50% occurred 1 month after birth, only 5% occurred 6 months after birth, more male than female, common in the upper lungs (to The left upper lobe is the most common, followed by the right middle lobe, and the unilateral pulmonary dysplasia is rare in the lower lobe.

an examination

Related inspection

Chest CT examination of chest flat tidal volume

X-ray findings in the lungs were mainly due to reduced peripheral texture and smaller hilar vessels.

Less lung texture is associated with congenital development and congenital heart disease. It may also be related to occlusion or reduction of blood vessels caused by acquired diseases. Also associated with long-term emphysema.

A decrease in lung texture refers to a sparse, thinned lung texture that can be seen in bilateral or unilateral lung fields. Most of its formation is the reduction of pulmonary vascular stenosis, so-called pulmonary ischemia is common in tetralogy of Fallot, pulmonary stenosis atresia, etc., mainly in the reduction of general lung texture, reduction of hilar vasculature, and pulmonary hypertension Then, the blood vessels around the hilar vasculature are suddenly thinned and reduced, and the air volume of the lungs is normal. When the emphysema is inflated, on the one hand, the capillary capillaries shrink and the lung volume is enlarged to disperse the lung texture. X-ray showed a decrease in peripheral blood vessel sparseness, normal or enlarged hilar vessels, and a large gas content in the whole lung.

Differential diagnosis

Increased lung texture can be seen in the following three cases:

(1) bronchial lung texture changes: the main pathology is thickening of the bronchial wall and inflammation of the surrounding interstitial, such as chronic bronchitis, bronchiectasis, etc., manifested as uneven thickness of the lung texture, which often has mixed deformation texture and small honeycomb Images, sometimes "orbital signs" can be seen, with two lung fields.

(2) Vascular lung texture changes: mainly caused by pulmonary congestion and pulmonary congestion. Pulmonary congestion is more common in congenital heart disease with left-to-right shunt, such as atrial septal defect, ventricular septal defect. This is due to the increase in pulmonary blood flow (arterial congestion), which causes the pulmonary artery to dilate. It is characterized by a coarser lung texture and a clearer edge, which maintains the characteristics of the blood vessels from the hilar to the lung field. Pulmonary congestion is more common in pulmonary vein dilatation caused by elevated pulmonary venous pressure after left heart failure. The lung texture is thickened, increased, and the edges are blurred. The lung field is obvious, and the lung field transmittance is reduced.

(3) Lymphatic lung texture changes: mainly seen in the lymphatic metastasis of the lungs. The cancer cells of lung metastasis are extensively infiltrated along the lymphatic vessels around the bronchus and veins, forming fine cancer cell lines. This change can be restricted to the vicinity of the hilum, and can also be extended to the lung field, and the lung texture is increased and thickened. Mesh shadow. X-ray findings in the lungs were mainly due to reduced peripheral texture and smaller hilar vessels.

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