胸部结节病的CT诊断

CT diagnosis of thoracic sarcoidosis

目的:分析胸部结节病的CT表现,提高对本病的认识和诊断水平。方法:回顾性分析经活检病理证实或临床治疗观察符合诊断标准的26例胸部结节病的CT表现。结果:26例结节病中,肺门、纵隔淋巴结肿大23例(88.5%),其中肺门或/和纵隔淋巴结肿大8例(30.7%),肺门或/和纵隔淋巴结肿大伴有肺内病变15例(57.7%),仅见肺部浸润性改变而无淋巴结肿大1例(3.8%),肺纤维性改变2例(7.7%)。肺内主要表现为结节影15例,支气管血管束增粗7例,小叶间隔增厚4例,实变影1例,磨玻璃影1例。结论:双侧肺门对称性淋巴结肿大和/或纵隔淋巴结肿大以及沿支气管血管束分布的结节影是胸部结节病的特征性表现;不典型者需密切结合临床检查及治疗后随访。

Objective： To analyze the CT apperances of the thoracic sarcoidesis, end to obtain a higher accuracy rate. Methods： The chest CT findings of 26 patients with proven sarcoidosis were reviewed. Results：23 cases （88.5%） had lymph node enlargement in bilateral hila end mediastinum on CT scan. 18 cases （56.5 % ） had pulmonary parenchymal abnormality. 1 case had abnormal findings in the lung alone without adenopathy. The most frequent findings of pulmonary parenchymal abnormality were nodules （ 15 cases） ,bronchovasular bundles thickening （7 cases） ,interlobular septal thickening （4 cases）, consolidation opacities （ 1 cases）, ground-glass opacities （ 1 cases）. Conclusion： The main feature of sarcoidosis in HRCT findings are symmetric lymph node enlargement in bilateral hila end/or mediastinum, nodules located along bronchovascutar bundles. Diagnosis of the atypical cases in diffcult end combination with clinical findings end follow-up is necessary.