韦格纳肉芽肿病肺部损害的CT分析

CT analysis of pulmonary Wegener's granulomatosis

目的探讨韦格纳肉芽肿WG肺部CT表现,提高对该病的诊断水平。方法总结分析经病理和临床证实的WG11例的肺部表现,其中胸片11例,胸部CT平扫加增强扫描8例。结果 11例中,肺部有异常表现10例。异常表现中片状浸润病灶3例,多发结节影(直径小于3cm)4例,肿块(直径大于3cm)3例,空洞8例,条状阴影1例。4例多种病灶混合存在。结论 WG肺部表现呈多样性,以片状浸润、结节和空洞病变最常见,薄壁空洞和环形空洞具特征性。此病要与肺炎、肺脓肿、肺结核和肺癌等疾病相鉴别。

Objective To study the CT features and to improve the diagnostic accuracy of pulmonary Wegener＇s granulomatosis. Methods 11 patients with histopathologically and clinically proven Wegener＇s granulomatosis were included in the study. Chest radiography was performed in all 11 patients and 8 patients underwent chest CT. Results Lung abnormalities were noted in 10/11 patients including patchy lung opacities （n = 3 ）, multiple nodules （less than 3cm in diameter, n = 4）, masses （more than 3cm in diameter, n = 3）, and cavitations （n= 8）. Multiple findings were observed in 4 patients. Conclusion Imaging manifestations of pulmonary Wegener＇s granulomatosis were variable. Patchy lung opacities, nodules and cavitation were most common. Thin-walled cavity and ring-shaped cavity were characteristic. Pneumonia, abscess, tuberculosis and carcinoma should be included in the differential diagnosis.