韦格纳肉芽肿病的临床及肺部影像学表现

Imaging and Clinical Manifestations of Pulmonary Wegener's Granulomatosis

目的:探讨韦格纳肉芽肿病的临床表现及肺部影像学特点,以提高对本病的认识。方法:回顾性分析经病理和临床资料证实的11例肺部韦格纳肉芽肿病患者的病例资料,总结其临床表现和肺部影像学特点。结果:11例中男7例,女4例,平均年龄42.3岁。主要临床表现为咳嗽、咯痰8例,咳血6例,胸痛3例;其它肺外表现为鼻塞5例,鼻衄2例。主要CT表现:6例显示有孤立性结节或肿块;3例表现为肺内多发性结节和空洞(其中1例出现坏死性空洞);1例为肺部斑片样渗出性病变;1例渗出和间质性病变同时存在。结论:韦格纳肉芽肿病可侵犯多个组织器官,双肺结节伴空洞形成是其典型的影像表现,临床症状与影像学表现相结合有助于本病的诊断。

Objective：To study the clinical and imaging characteristics of pulmonary Wegener＇s granulomatosis,in or der to enhance the knowledge of the disease. Methods：The imaging and clinical characteristics of eleven patients with clinical and pathology proved pulmonary Wegener＇s granulomatosis were retrospectively analyzed. Results：Of the 11 patients,there were male （n= 7）, female （n 4 ） ;the average age was 42.3 years. The clinical features were cough and expectoration （8 cases） ,hemoptysis （6 cases） and chest pain （3 cases）;the other extra-pulmonary manifestations were nasal obstruction （5 cases） and epistaxis （2 cases）. The main CT features were solitary pulmonary nodules or masses （6 cases） ,multiple pulmonary nodules with cavitation （three cases,one case had necrotizing cavity）, patchy exudative lesions （one case） and interstitial tissue invasion accompanied with exudative lesions （1 case）. Conclusion： Multiple organs/tissues invasion could be revealed in Wegener＇s granulomatosis. The typical manifestations are bilateral pulmonary nodules accompanied with cavitation. Clinical symptoms correlated with imaging findings are helpful for the definite diagnosis.