CT像上支气管充气征的再分析

Further analysis of air bronchograms on CT images

目的探讨CT像上支气管充气征的分型及其在鉴别诊断中的意义。方法收集2005年5月至2007年6月有完整影像、临床及病理资料的27例肺部CT,部分病例有完整的系列随访片,所有的病例均呈大片状病变表现,在大片状病变中见到明确的支气管充气征,其中,大叶性肺炎6例,过敏性肺炎1例,肺泡性肺水肿2例,右肺中叶慢性炎症伴不张3例,横膈抬高致右下肺部分不张3例,肺结核3例,肺黏膜相关淋巴瘤2例,中央型肺癌致阻塞性炎症不张4例,细支气管肺泡癌3例;详细观察充气支气管的改变并按照不同表现将支气管充气征分型,分析其与肺部大片状病变的关系。结果依据充气的支气管出现的管腔、管壁、走行形态等多种改变,本组支气管充气征分为4型,Ⅰ型即青枝型(9例),Ⅱ型即扩张型(8例),Ⅲ型即枯枝型(7例),Ⅳ型即复合型(3例)。结论不同类型支气管充气征往往是不同性质病变的反应,通过对不回类型支气管充气征的详细分析,对肺部大片状病变的鉴别诊断有一定帮助。

Objective To investigate the typing of air bronchograms on CT images and its significance in the differential diagnosis. Methods The imaging,clinic and pathologic data of 27 patients with air bronchograms on CT images were collected from May 2005 to June 2006 and retrospectively analyzed.All the patients were confirmed by histopatholngy,of whom,lobar pneumonia was found in 6,aller- gic pneumonia in 1, alveolar pulmonary edema in 2,chronic right middle lobe inflammation associated with atelectasis in 3,local right lower lobe atelectasis induced by diaphragmatic elevation in 2,obstructive atelectasis induced by central lung cancer in 4,and bronchiolous alveolar carcinoma in 3.The typing of air bronchograms in all patients was performed according to the varied changes of bronchi on CT images and their correlation with intrapuhnonary consolidation lesions.Results According to different changes of the broneheal eavity ,wall and walking shape,the air brmchograms in the group were classified into four types which comprised greenstick type （n=9）,dilatation type （n=8）.wither-stick type （n=7）,and compound type（n=3）.Conclusion The typing of air bronchograms suggests that the presence of different air bronchograms in consolidation lesion is helpful to differentiate malignant from benign lesions.