摘要
目的对使用64层螺旋CT检查白 血病肺浸润患者的影像学检查进行研究分 析,探讨该检查方式对于白血病诊断的临 床价值。方法 将我院2008年1月-2014年1 月期间收治的20例确诊为白血病肺浸润患 者纳入本次研究,对所有患者的影像学资 料进行回顾性分析。结果 白血病肺浸润 患者的胸部CT表现多种多样,其中最为常 见的为间质病变(100.0%),特别是以小 叶间隔增厚最为显著;其次为毛玻璃样病 变(30.0%);结节状改变(20.0%);气 腔实变(10.0%),实变部位以双肺下叶 多见。结论 白血病患者一旦出现胸部症 状时,应当考虑是否为肺浸润,采用螺旋 CT对患者肺部进行检查具有一定的辅助作 用,但要注意与其他并发症进行鉴别。
Objective This paper is to explore imageological examinations of patients applying 64 layers of spiral CT to check leukemia pulmonary infiltration, and to explore clinical value of inspection method on leukemia diagnosis. Methods Twenty patients confirmed to suffer from leukemia pulmonary infiltration admitted by this hospital during the period from January, 2008 to January, 2014 were incorporated into this study, and the imaging data of all patients were retrospectively analyzed. Results The chest CT manifestations of patients with leukemia pulmonary infiltration varied, one of the most common manifestations was interstitial lesion (100.0%), especially interlobular septal thickening was most significant, followed by ground-glass opacity lesion (30.0%), nodular lesion (20.0%) and air cavity consolidation (10.0%), and the lung field under the consolidation area was the most common. Conclusions The existence of pulmonary infiltration should be taken into consideration once patients with leukemia assume chest symptoms, the application of spiral CT to examine the lunges of patients delivers certain supporting role, but it should be noted it should be distinguished from other complications.
【关键词】白血病浸润;肺;螺旋CT;体层成像
【中图分类号】R733.7; R445.3
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2015.04.17
前言
白血病属于造血干细胞发生克隆性恶性病变的一种疾病,发生病 变的细胞会逐渐失去分化的能力,使其停留在细胞发育的各个阶段。 患者在疾病的进展过程中,通常会合并部分肺组织并发症,包括感 染、出血、药物毒性反应等。国外学者报道指出[1],在对白血病患者 进行尸检时发现肺部出现并发症的几率高达98%,而肺浸润的发生率 在26%~92.6%之间。现阶段对于肺浸润患者的检查方式多采用活检, 但活检技术上由于受到一定限制,所以诊断阳性率并不高[2]。我院对 2008年~2014年的20例白血病肺浸润患者的CT结果进行了分析,旨在 总结螺旋CT对白血病浸润患者的影像学表现,为今后的临床诊断提供 参考意见,现将结果整理如下。
中国CT和MRI杂志
第13卷, 第 4 期
2015年04月
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