隐原性机化性肺炎的CT征象分析

The cryptogenic organizing pneumonia:the analysis of CT features

目的提高对隐原性机化性肺炎(COP)影像表现的认识。方法回顾性分析23例经肺活检病理证实为 COP 患者的影像表现。结果 23例患者中 CT 表现为多发性斑片状含气实变影15例,主要分布在胸膜下区和双肺下叶。14例伴有磨玻璃影及小支气管扩张,还有条索状影。6例有病灶游走的表现。21例对肾上腺皮质激素治疗有显著疗效。结论隐原性机化性肺炎的诊断需结合临床表现、影像、病理等检查结果综合分析,对 CT 表现的认识非常重要。

Objective To improve our understanding concerning radiographic manifestations of cryptogenic organizing pneumonia （COP）. Methods The diagnosis of cryptogenic organizing pneumonia was made based on clinical and radiologlcal features, and was verified with lung biopsy and pathological examination in 23 cases. All data were analyzed and relevant literatures were reviewed. Results CT scans revealed multi- patch shadows, patchy air-space consolidations in 15 cases, often located in predominantly subpleural and（or） both inferior lungs, with or ground-glass opacities, bronchiectasis, and cords. Lesion sites changed over time in some patients. Corticosteroid treatment led to significant improvement in most cases. Conclusions The diagnosis of cryptogenic organizing pneumonia required the converging evidence from clinical and radilogical manifestations as well as pathologies. It is important to appreciate CT manifestations of COP.