全肺灌洗治疗前后肺泡蛋白沉积症的高分辨率CT表现

High Resolution Computed Tomograghy Features in Pulmonary Alveolar Proteinosis before and after Whole Lung Lavage Therapy

目的探讨肺泡蛋白沉积症胸部高分辨率计算机断层扫描(HRCT)表现及全肺灌洗治疗后HRCT的变化特点。方法回顾性分析16例23人次肺泡蛋白沉积症患者全肺灌洗治疗前后的HRCT资料。结果全肺灌洗治疗前胸部HRCT表现为两肺弥漫性地图样分布边界清晰的斑片状磨玻璃影,伴小叶间隔增厚,呈"铺路石"征。全肺灌洗治疗后HRCT显示肺部磨玻璃影不同程度变淡,范围缩小,但仍遗留不同范围的网格状阴影及实变影。结论肺泡蛋白沉积症的HRCT表现具有相对特征性,即地图样分布的磨玻璃影伴小叶间隔增厚。全肺灌洗治疗后HRCT的表现明显改善。

Objective To study high resolution computed tomograghy （HRCT） features and changes of HRCT after whole lung lavage therapy in patients with pulmonary alveolar proteinosis （PAP）. Method We retrospectively reviewed the HRCT data of 23 times of lung lavage therapy in 16 PAP patients. Results HRCT scan showed bilateral clearly-defined patchy areas of ground-glass opacity and interlobular septal thickening, a pattern commonly characterized as ＂crazy paving＂ . After whole lung lavage therapy, HRCT showed that the diffused ground-glass opacity palliated and the extent of lung opacity shrinked, while the reticular opacity and area of confluence persisted. Conclusion The HRCT feature of PAP is relatively characteristic, and may be improved after whole lung lavage therapy.