多层螺旋CT对肺部磨玻璃影的诊断与鉴别诊断分析

Diagnosis and differential diagnosis of pulmonary ground-glass opacities with multi-layered spiral CT

目的探讨多层螺旋CT对肺部磨玻璃影的诊断及鉴别诊断价值。方法选择我院2008年10月~2011年5月诊治的46例CT肺部表现为磨玻璃影的患者资料,分析磨玻璃影的分布特征、伴随征象,以及最终的临床诊断结果,探讨不同疾病的肺部磨玻璃影特征。结果 46例肺部疾病患者中,14例经肺部穿刺确诊,20例经支气管镜及实验室检查确诊,12例经临床确诊。其中,间质性肺部疾病26例,磨玻璃影主要表现为外周型、局限型,多边界模糊;肺实质病变12例,磨玻璃影主要表现为中央型、局限型,但边缘多清晰;8例患者诊断为阻塞性通气功能障碍,磨玻璃影外周型与中央型均较常见,多伴随病灶区蜂窝状细网及小血管增粗表现。结论肺部磨玻璃影可见于肺间质病变、实质病变及阻塞性肺疾病等,虽然其不是一种疾病的特异性,但不同疾病的肺部磨玻璃影仍有不同的形体分布及伴随征象,有利于临床缩小诊断范围。

Objective To explore the value of multi-layered spiral CT in the diagnosis and differential diagnosis of pulmonary ground-glass opacities.Methods To analyze data of patents in our hospital from October 2008 to May 2011 of which lung CT showed ground-glass opacities,to analyze the distribution of ground glass,incidental signs and ultimately clinical results in order to explore different diseases pulmonary ground-glass features.Results In the 46 patients with pulmonary disease,14 patients were diagnosed with lung puncture,20 patients were diagnosed with bronchoscopy and laboratory,12 patients were diagnosed by clinic.Of these,26 cases of interstitial lung disease,ground-glass opacities were mainly peripheral and limit,and the boundary was fuzzy.Pulmonary parenchymal disease in 12 cases,ground-glass opacities was central and limit,but the edge was clearly.8 patients were diagnosed with obstructive ventilatory dysfunction,ground-glass opacities were peripheral and central in common,and more with fine mesh honeycomb lesions and small vessel thickening performance.Conclusion Pulmonary ground-glass opacities is common in interstitial lung disease,pulmonary parenchymal disease and obstructive disease,although it is not a specific sign,but there are different ground-glass shadow signs in different lung diseases,and this will help narrow the diagnosis of clinical range.