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| Imaging findings and follow-up observation of aspiration pneumonia injury caused by liquid ammonia poisoning |
| ZHAO Hong-quan1, KONG Li-li1, CHENG Yong-yuan2, SUN Hai-cheng2 |
| 1. Department of Imaging, Yantai Economic and Technological Development Zone Hospital, Yantai Shandong 264006, China;2. Department of Radiology, Laiyang Central Hospital, Laiyang Shandong 265200, China |
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Abstract Objective: To retrospectively analyze imaging manifestations of aspiration pneumonia caused by acute ammonia poisoning and investigate its changing process. Materials and Methods: In an accident, 30 healthy young people suffered from acute ammonia poisoning(9 males and 21 females). All the chest imaging data were reviewed, and special emphasis was put on follow-up CT imaging manifestation of 19 moderate to severe cases. Results: Of the 30 cases, 11 mild poisoning(36.7%) were cured in seven days. Pulmonary texture became increased and fuzzy from their X-ray examinations and there were no abnormality on follow-up CT images after 10 months. For 10 cases of moderate poisoning(33.3%) in acute phase, CT images showed fuzzy broncho-vascular markings in 10 cases, spotty shadows in 4 cases, and tree-in-bud sign with small lamellar shadows in 1 case. After 3 months, the results of CT manifestations were no abnormal findings in 6 cases, local mild fibrosis in 4 cases. For 9 cases(30%) of severe lung injury within 2 months, 6 cases showed signs of alveobronchiolitis with patchy shadows varying in size, ground glass opacity(GGO) and “mosaic” sign. Two cases showed signs of bronchiolar inflammation and obstruction, which was characterized by diffuse distribution of “tree-in-bud” and quick formation of necrotic cavity. One case showed multiple lung tissue injuries and formation of necrotic cavities, complicated with pneumothorax, liquid pneumothorax, subcutaneous and mediastinal emphysema etc. After 3 months, lung injuries became chronic. Small shadows and “tree-in-bud” were absorbed gradually. Pneumothorax, subcutaneous and mediastinal emphysema were reduced. The cavum took the place of thick wall cavities. But the absorption of GGO and “mosaic sign” took a long time. Conclusion: Varied manifestation could occur during aspiration pneumonia owing to liquid ammonia poisoning with complex changes in severe cases. CT imaging manifestations played an important role in observing lung injuries.
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Received: 05 May 2014
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2015, Vol. 26 
