Image findings in thoracic trauma: pulmonary parenchyma injuries

Introduction: although frequent and with great clinical importance, imaging findings of pulmonary contusions have been poorly studied in recent years, particularly using multidetector computed tomography scanners. Thus, we intend to evaluate pulmonary parenchymal lesions using multidetector tomography, correlate imaging findings with trauma severity and make comparisons regarding the presentation between adults and children. Methods: 53 patients with pulmonary contusions had their computed tomography images and their medical record data analyzed retrospectively in search of variables related to the imaging patterns of pulmonary parenchymal lesions and associated pulmonary or extrapulmonary injuries. Children and adults were compared regarding distribution of the lesions, opacities types, fissure crossing and subpleural sparing. Need for supplementary oxygen or mechanical ventilation were compared between patients with only ground-glass opacities and with at least one area of consolidation. Results: there are only available data on pulmonary contusions until now and the pattern of lesions was non-segmental patchy or diffuse opacities, usually with at least two lesions in the same patient (79.3%). Our data about distribution reveal a tendency of contusions to be posterior and peripheral lesions, with preferential involvement of lower portions of the lungs. There was no statistically significant difference between patients with only GGO and with at least one mixed lesion/consolidation related to need for supplementary O₂ or MV. Children and adults had no statistically significant difference regarding the frequency of fissure crossing and subpleural sparing. Adults, however, present more GGO than children. (author)