25例肺部受累的原发性小血管炎的HRCT表现及临床分析

HRCT features and clinical analysis in 25 cases of primary small vessel vasculitis with lung involvement

目的研究肺部受累的原发性小血管炎的HRCT表现等临床特点。方法对本院2004年1月~2010年1月收治的肺部受累的19例显微镜下多血管炎（MPA）患者及6例变应性肉芽肿性血管炎（CSS）患者的临床资料进行回顾性分析。结果 19例MPA的肺部HRCT表现有：（1）两肺弥漫浸润性阴影、类似肺间质性改变12例;（2）肺内多发斑片影7例。6例CSS的肺部HRCT均表现为多发斑片影。19例MPA中抗中性粒细胞胞浆抗体（ANCA）阳性18例,阳性率高达94.74%。6例CSS中ANCA阳性1例。结论肺部受累的原发性小血管炎HRCT影像学表现无明显特异性,结合临床及实验室检查,可以提高认识,早期诊治。

Objective To study the chest HRCT features and clinical characteristics of small vessel vasculitis with lung involvement.MethodsClinical data of 19 patients of MPA and 6 patients of CSS with lung involvement,from Jan.2004 to Jan.2010,were retrospectively analyzed.ResultsThere are two types of lung imaging manifestations in 19 MPA cases：（1） Diffuse patchy opacity in both lung similar to lung interstitial involvement in 12 cases.（2） Multiple patchy opacity in both lungs in 7 cases.The chest HRCT in all 6 cases of CSS shows multiple patchy opacity.94.74 percent（18/19）of these MPA cases were ANCA positive,while 1/6 of CSS cases.ConclusionsThe HRCT manifestations of MPA and CSS with lung involvement have no characteristic features.Clinical characteristics and laboratory examination can help to understand and diagnose MPA and CSS with lung involvement early.