肺淋巴管肌瘤病多层螺旋CT诊断价值

Pulmonary lymphangiomyomatosis: multi-slice spiral CT findings

目的:通过分析肺淋巴管肌瘤病(PLAM)多层螺旋CT(MSCT)的影像特点,旨在探讨其对肺淋巴管肌瘤病(PLAM)的影像诊断价值。方法:回顾性分析12例经病理证实的PLAM的胸部影像表现,包括常规扫描、横轴面薄层重组和冠状面、矢状面多平面重组(MPR)图像。结果:12例成年女性患者胸部MSCT典型征象为:双肺弥漫分布大小不等的类圆形囊腔影,常规层厚图像显示囊腔影的径线5～30mm,较小的囊腔影不能显示明确的薄壁。薄层重组和MPR图像可明确显示囊腔壁,壁厚<2mm,囊壁可见散在的血管断面影和血管穿插其中。气胸5例,乳糜胸3例,1例合并前纵隔淋巴结肿大。结论:MSCT薄层重组和冠状面、矢状面MPR对该病的早期诊断、鉴别诊断具有重要价值,同时也是判断病变进展及预后的有效指标。必要时需行肺活检,以明确病理诊断。

Objective：To study multi-slice spiral computed tomograghy（MSCT） features in pulmonary lymphangiomyomatosis （PLAM） and discuss the diagnostic value of MSCT in tiffs disease. Methods： The pulmonary imaging data of 12 pathologically proven cases with PLAM were performed with multi-slice spiral computed tomograghy （MSCT）, including conventional slice thickness, axial thin section and coronal and sagittal MPR images, were retrospectively analyzed.Results：Among these 12 female adults, the data of MSCT were typically featured by multiple diffuse lung parenchyma cysts, the diameter of cysts were 5 - 30 mm in conventional slice thickness, thin wall of small cysts could not be seen, but thin section of reconstruction images and MPR images could depict thin wall of cysts,thickness of the wall were less than 2 mm, also clearly showed sporadic vessels on cyst wall. 5 cases accompanied with pneumothorax, 3 cases with chylothorax, 1 cases with anterior mediastinum lymph node enlargement. Conclusion： The conventional slice thickness, axial thin section and coronal and sagittal MPR images of MSCT are valuable modalities in the early diagnosis and differential diagnosis of of PLAM, furthermore, it provides effective imaging evidences for the evaluation of the progress and prognosis of the disease as well.