高分辨率CT对弥漫性肺疾病诊断的评价

Evaluation of Higk Resolution CT in The Diagnosis of Diffusc Discases of The Lung

笔者对１６个正常成人新鲜肺叶标本进行了ＣＴ－高分辨率ＣＴ（ＨＲＣＴ）－标本对照研究，分析了５０例正常成人胸部ＣＴ和ＨＲＣＴ图像。结果表明：ＨＲＣＴ在显示肺部细小结构方面明显优于常规ＣＴ。笔者还分析了３０例弥漫性肺疾病的ＨＲＣＴ征象：（１）小叶间隔增厚；（２）蜂窝肺；（３）磨玻璃样表现；（４）胸膜下线；（５）小结节。小叶间隔不规则增厚伴小叶结构变形常见于肺间质纤维化。肺淋巴管转移癌小叶间隔亦增厚，但无小叶结构变形。“小叶间隔串珠”征高度提示肺淋巴管转移癌。

This study consisted of 16 isolated.inflated fresh specimens of lung lobes scanned with high resolution CT(HRCT)and was correlated with lung sections obtained at the same level.CT and HRCT chest images of 50 normal individuals were also analyzed.The results showed that HRCT is supe-rior to conventional CT in demonstrating pulmonary structure.The HRCT appearances of 30 cases of diffuse lung diseases were also analyzed, these included: (1)septalthickening;(2)honcycombing;(3)groundglass appearance;(4) the subpleural line;(5)small nodules.Irregular thickening of interlobular septa accompanied by distortion of lobular configuration is fre-quently seen in idiopathic pulmonary fibrosis(IPF),whereas in pulmonary lymphangitic carcinomatosis,the thickened septa have smooth margins,the without structural distortion. Multiple nodules in septa the“beaded septa”sign is highly suggestive of pulmonary lymphatic metastasis.