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HRCT对特发性肺间质纤维化的鉴别诊断价值临床研究

作者:马 磊

所属单位:河南省新乡市第二人民医院CT室 (河南 新乡 453000)

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摘要

目的 分析HRCT(高分辨率CT)对特发性肺间质纤维化的诊断价值。方法 回顾收集经病理证实的56例特发性间质性肺 炎患者影像学资料,患者均进行HRCT扫描,根据扫描结果判断疾病分布,并分析不同时期的成像特点。结果 HRCT 主要表现有磨玻璃样阴影改变、网状改变、蜂窝状改变、胸膜下间质纤维化等特点,本次56例患者中,46.4%为早 期患者,HRCT图像表现为磨玻璃样、小叶内间质增厚、小叶间隔增厚表现;53.6%为非早期患者,除上述症状,还 出现胸膜下弧线影及蜂窝肺,其中小叶间隔增厚所占比例最高。结论 不同时期的特发性肺间质纤维化HRCT各有特 点,其成像结果能有效反映病变情况,可用于特发性肺间质纤维化鉴别诊断。

Objective To analyze the diagnostic value of HRCT (high resolution CT) on idiopathic pulmonary fibrosis. Methods The imaging data of 56 patients with idiopathic interstitial pneumonia confirmed by pathology were retrospectively collected. All patients were given HRCT scan. The disease distribution was judged according to the scan results, and the imaging characteristics of different periods were analyzed. Results HRCT showed the ground glass-like shadow change, reticular change, honeycomb change and subpleural interstitial fibrosis. Among the 56 patients, 46.4% were early patients, and the HRCT images showed ground glass, intralobular interstitial thickening and interlobular septal thickening. And 53.6% were non-early patients, and the images showed subpleural arc shadow and honeycomb lung in addition to the above symptoms, and the percentage of interlobular septal thickening was the highest. Conclusion The HRCT of idiopathic pulmonary interstitial fibrosis in different periods has its own characteristics. And its imaging results can effectively reflect the lesions and can be used for the differential diagnosis of idiopathic pulmonary interstitial fibrosis.

【关键词】高分辨率CT;肺间质纤维化;诊断

【中图分类号】R563.1+3

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2019.02.017

前言

特发性间质性肺炎(idiopathic interstitial pulmonary fibrosis,IPF)是一种广泛纤维性肺泡 炎,主要以肺泡壁为主要病变引起的一种异质性组成 的疾病谱,其病因尚未明确,目前认为与机体免疫系 统功能紊乱有关[1]。IPF影响患者的呼吸功能、心脏 等循环系统,终末期患者还可出现蜂窝肺,多数患者 可出现呼吸衰竭,生存时间短、生活质量差[2-3]。IPF 的诊断金标准是肺组织病理检查,但属于有创操作, 且不具备灵活性,影像学筛查的操作简单、可反复操 作、阅片,对患者影响较小,可作为初级诊断方法。 HRCT(高分辨率CT)具有良好的扫描空间分辨率,可 清楚观察IPF患者的肺组织细微结构,有利于疾病的 诊断。现以本院56例IPF患者的影像学资料为观察对 象,分析HRCT在IPF的成像结果,评估其诊断价值。