肺韦格肉芽肿的CT特征分析

CT manifestations analysis of Wegener granulomatosis in lung

目的:探讨肺部韦格肉芽肿的CT表现特点和鉴别诊断价值。方法:对10例经肺穿刺活检和临床综合资料证实的韦格肉芽肿病人的肺部CT表现进行回顾性分析。结果:6例表现为肺内多发性结节和空洞。2例见肿块,所有肿块均出现空洞。2例可见基底贴附于胸膜面的楔形阴影,楔形阴影内密度不均,5例显示供养血管征。4例毛玻璃样改变和实变。4例支气管管壁增厚,1例见气管狭窄。3例支气管扩张。胸膜粘连和胸腔积液各1例。结论:肺内多发性肺结节伴空洞、楔形灶、毛玻璃样改变和实变对肺韦格肉芽肿具有相对特异性,"供养血管征"是本病重要特征之一。而这些病灶的特殊变化规律更具诊断价值。

Objective： To evaluate CT manifestations and the value of diagnosis of Wegener granulomatosis of lung. Methods： All the CT findings of the 10 cases with Wegener granulomatosis in lung confirmed clinically or by operation were analyzed retrospectively. Results： Nodules and cavitations were seen in 6 patients. Masses with cavitations were seen in 2 patients. Wedge-shaped areas of peripheral consolidation without uniform density abutting the pleura were seen in 2 patients. A feeding vessel sign to a nodule or mass were seen in 5 patients. Ground-glass attenuation and consolidation were seen in 4 patients. Bronchial wall thickening was discovered in 4 patients, tracheestenosis was seen in 1 patient, bronchiectases were found in 3 patients. Pleural irregularities were seen in 1 patient and pleural effusion was seen in 1 patient. Conclusion： Nodules and cavitations, wedge-shaped areas of peripheral consolidation, ground-glass attenuation and consolidation in lung are specific signs in diagnosing Wegener granulomatosis in lung. A feeding vessel sign to a nodule or mass is also one of its important characteristics, and all these special developments are more important for us to diagnose Wegener granulomatosis in lung.