磨玻璃样改变的HRCT检查及其对弥漫性肺疾病的诊断价值

Ground Glass Opacity:The Role of High Resolution CT inDiagnosing Diffuse Pulmonary Diseases

评价肺部磨玻璃样改变的高分辨率ＣＴ（ＨＲＣＴ）检查、病理基础以及它在弥漫性肺疾病（ＤＰＤ）中的诊断价值。材料和方法：一组连续的经病理学检查或临床综合其它各种检查而明确诊断的弥漫性肺疾病，经普通Ｘ线、ＣＴ和ＨＲＣＴ检查，ＨＲＣＴ采用层厚为１－１．５ｍｍ，间隔为１０ｍｍ，高空间频率重建算法。有病理学结果者则与之对照。结果：本组ＤＰＤ包括７３例，ＨＲＣＴ显示磨玻璃样改变征象１６例，分别为过敏性肺炎５例、淋巴瘤ｌ例、皮肌炎２例、特发性肺纤维化３例、类风湿性肺炎２例、放射性肺炎１例和肺水肿２例。普通Ｘ线仅显示９例（Ｐ＜０．０１）。病理学上磨玻璃样改变由肺泡腔内渗出、肺泡间隔增厚所致。结论：ＨＲＣＴ是显示肺部早期异常表现——磨玻璃样改变十分有效的方法，但对弥漫性肺疾病的鉴别诊断缺乏特异性。

Purpose:To assess the role of groud glass opacity in diagnosing diffuse pulmonary diseases and to investigate the value of high resolution CT(HRCT) in detecting the findings of groud glass opacity.Materials and Methods:Consecutive patients(n=73) proved by pathology or clinical criteria were examined by chest plain films,CT,and HRCT scans on the same day or within interval of 7 days.On HRCT,1-1.5mm collimation scans with high spatial frequency reconstruction algorithm were obtained.HRCT-pathologic correlation has been done in 3 cases.Results:Ground glass opacities were demonstrated by HRCT in 16 cases including 5 cases of hypersensitivity pneumonitis,1 case of non-Hodgkin's lymphoma,2 cases of dermatomyositis,3 cases of idiopathic pulmonary fibrosis(IPF),2 cases of rheumatoid arthritis,1 case of radiation pneumonia and 2 cases of pulmonary edema.On chest radiography,only 9 patients of ground glass opacity were detected(P<0.01).Pathologically,ground glass opacity was caused by fluids and celluar debris filled within air space and thickening of alveolar walls.Conclusion:HRCT is more sensitive than chest film in differential diagnosis of diffuse pulminary diseases.