弥漫性泛细支气管炎的HRCT诊断

CT Diagnosis and differentiation of diffuse panbronchiolitis

目的提高对弥漫性泛细支气管炎(DPB)的CT表现的认识,探讨CT对DPB的诊断和鉴别诊断价值。方法回顾性分析2003年6月-2007年12月本院收治的DPB51例,其中病理活检确诊3例,临床诊断48例。结果1.胸部CT征象:①弥漫性细粟粒样影伴树芽征,无融合趋势,占88.24%;②小(细)支气管扩张,表现为小气道支气管"双轨征"和环状透光影,部分病例可见支气管壁增厚,占66.67%;③炎性斑片影,多为小斑片影,占52.94%。2.副鼻窦CT检查时多有慢性副鼻窦炎表现,本组病例占73.33%。结论CT是DPB诊断中必要手段,高分辨率CT(HRCT)是最佳显示方法,副鼻窦CT检查可为鉴别诊断提供佐证。

Objective To evaluate HRCT manifestations of diffuse panbronchiolitis （DPB） and the diagnosis. Methods fourtythree patients collected from June 2003 to December 2007 were retrospectively analyzed including pathologically diagnosis（n=3 cases）, clinical-diagnosis （n=48 cases） （refer to Japanese secondary revised diagnostic criteria）. Resultes 1.The CT appearances of DPB were as follow： （1） Diffuse miliary pulmonary signs accompanied by tree-in-bud sign（88.24%）, with fusion tendency; （2） Small airway bronchiectasis（66.67% ）, such as the bronchiolar double track sign and small crico-lucency signs with bronchial wall thickening; （3） Small inflammatory patching signs（52.94 %）. 2. Chronic paranasal rhinitis（73.33 %） by CT examination of accessory nasal cavity. Conclusion HP, CT is an indispensable method for diagnosing DPB. CT examination of accessory nasal cavity may provide significant diagnotic evidence.