胸部结节病的CT诊断与鉴别诊断

CT Diagnosis and differential diagnosis of thoracic sarcoidosis

【目的】回顾性分析胸部结节病的CT表现,进一步提高对此病的认识,减少误诊。【方法】分析47例符合诊断标准的胸部结节病的CT表现。【结果】胸部淋巴结增大47例,其中纵隔淋巴结增大46例,双侧肺门淋巴结增大45例,一侧肺门淋巴结增大而无纵隔淋巴结增大1例。肺部病变30例,其中多发结节21例,单发结节1例,磨玻璃样影9例,支气管血管束增粗15例,实变5例。胸膜病变11例。【结论】有典型影像学表现的胸部结节病诊断容易;不典型者诊断困难,需密切结合临床及治疗后随访。

[Objective] To analyze the CT appearances of thoracic sarcoidosis retrospectively and to obtain a higher accunrate rate and reduce misdiagnosis. [Methods] CT appearances of 47 cases with proven thoracic sarcoidosis were analyzed retorospectively. [Results] In 47 cases enlarged thoracic lymph nodes could be detected. 46 of them had mediastinal lymph node enlargement, 45 of them had bilateral hilar lymph node enlargement, 1 of them had unilateral hilar lymph node enlargement and no mediastinal lymph node enlargement. In 30 cases there were abnonrmal findings in the lungs. Twenty one of them had multiple nodes, 1 of them had single nodes, 9 of them had groundglass opacities, 15 of them had thickened bronchi and vessels, 5 of them had consolidation. [Conclusions] Diagnosis of the thoracic sarcoidosis with typical imaging appearances is easy. Diagnosis of the atypical cases is difficult and combination with clinical findings and follow - up is necessary.