特发性肺纤维化的16层螺旋CT表现特征及其解剖、病理基础

16-detector Row CT Features and Related Anatomic-pathology Basis of Idiopathic Pulmonary Fibrosis

为明确特发性肺纤维化(idiopathic pulmonary fibrosis,IPF)的16层螺旋CT表现特征、合并症及其解剖的优势分布。对临床病理证实的IPF38例行16层螺旋CT检查,其中26例追加薄层CT扫描。观察IPF的CT征像和合并症,评价其CT征像在解剖中优势分布。其中蜂窝肺14例(36.8%),10例(71.4%)主要分布于中下肺的外带、以双肺下叶基底段显著,4例(28.6%)呈弥漫性分布,11例(78.6%)病程在3年以上。小叶内间质增厚16例(42.1%)、小叶间隔增厚20例(52.6%)及支气管血管束增粗9例(23.7%),分别优势分布于中下肺的外带、双肺下叶基底段,双肺下叶及右肺中叶中内带。磨玻璃样密度影15例(39.5%),优势分布于肺的外带,主要以双肺下叶基底段显著;其中10例(66.7%)病程在1年以下。结果表明IPF的16层螺旋CT征象能反映其病理变化,在解剖分布上有明显特点。

The objective of this study was to elucidata the correlation of 16-detector row CT features with the complications and anatomic-pathology of the disease in patients with idiopathic pulmonary fibrosis（IPF）.The 16-detector row CT appearances and predominant anatomic distribution were analyzed in 38 cases of IPF.Of the 14 patients（36.8%） with honeycomb lung,10（71.4%） had honeycomb appearances predominantly distributed in the peripheral zone of the middle and lower lobes,particularly in the basal segments of the lower lobes.11 patients（78.6%） had the clinical duration of honeycomb lung for more than 3 years.The interlobular interstitial thickening was seen in 16 cases（42.1%）,the interlobular septa thickening in 20 cases（52.6%）;and the thickened bronchus-vascular bundle in 9 cases（23.7%）.The above-mentioned three kinds of CT features observably distributed in the peripheral zone of the middle and lower lobes,in the basal segments of the lower lobes,and in the lower lobes and middle lobe of right lung in the middle of the zone,respectively.In 15 patients（39.5%）,ground-glass opacity was predominantly distributed in the peripheral zone of lung and in the basal segments of the lower lobes;and the clinical duration lasted less than 1 year was seen in 10 cases（66.7%）.These results indicated that some characteristic manifestations with pathologic variation and predominant anatomic distribution of IDF can be shown on 16-detector row CT.