隐原性机化性肺炎的临床影像学特点研究

Clinicoradiologic features of cryptogenic organizing pneumonia

目的探讨隐原性机化性肺炎(COP)的临床和影像学特征,以提高临床诊断水平。方法对经开胸肺活检病理确诊的8例COP患者的临床、病理和影像学资料进行回顾性分析。结果8例COP患者,男5例,女3例;年龄37～68岁。主要的症状和体征为气短、咳嗽及吸气性爆裂音。胸部X线胸片和HRCT影像学表现有磨玻璃影、含气实变影、条索状影、结节影和网状影等。提示COP诊断的典型胸部CT表现有:胸膜下分布的斑片状或大叶性气腔实变影;沿支气管血管束分布和/或胸膜下分布的不规则条索状影。所有患者均给予糖皮质激素治疗,7例患者病情缓解或改善。结论CT影像学特征结合临床资料,对COP的诊断有一定的提示作用,但病理检查为确诊手段。多数COP患者对糖皮质激素有较好的反应和预后。

Objective To analyze the clinical presentations and radiologieal characteristics of pathologically proved cases of c .ryptogenlc organizing pneumonia （COP）. Methods The clinical and radiological features of 8 patients with COP confirmed by open lung biopsy were analyzed. Treatment and follow-up data were also recorded. Results There were 5 male an 3 female patients aged 37 to 68 years. Dyspnea,cough and inspiratory crackles were the most common symptoms and signs. Various computed tomography findings including ground glass opacities, pathy consolidation with air bronchograms, nodules and reticulation were simuhaneously observed in the same patient. The diagnostic imaging features of COP were patchy or lobar consolidation, often by a predominantly subpleural distribution, and irregular band-like opacities distributed along the bronchovascular bundle or located in the subpleural area. All patients were treated with corticosteroids and yielded significant improvement in seven cases. Conclusions COP could be diagnosed by clinical and radiological findings and histopathological examination was needed for confirmed diagnosis. In general,COP responds well to glucocorticoid therapy and has a benign prognosis.