肺磨玻璃病变的CT特征分析

The diagnosis and differential diagnosis of pulmonary ground-glass opacities with multi-slice 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。方法回顾分析46例肺部CT表现为磨玻璃影的分布特征及伴随征象。结果本组46例中,16例经肺部穿刺确诊,19例经支气管镜及实验室检查确诊,11例患者经临床确诊。其中,24例间质性肺部疾病患者,磨玻璃影主要表现为外周性、局限性,多边界模糊。肺实质病变11例,磨玻璃影主要表现为中央型、局限性,但边缘多清晰。11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,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 analyze data of 46 cases of patients with ground - glass shadow and to explore the value of muhi - slice spiral CT in the diagnosis and differential diagnosis of pulmonary ground - glass opacities. Methods Data of patients in our hospital of which lung CT showed ground - glass opacities were analyzed, the distribution of ground glass, combined signs, and ultimately clinical findings were studied, and different diseases pulmonary ground - glass features were explored. Results In the 46 patients with pulmonary disease, 16 pa- tients were definitely diagnosed with lung puncture, 19 patients with bronchoscopy and laboratory, and 11 patients by clinic. Of these, there were 24 cases of interstitial lung disease, in which ground - glass opacities was mainly peripheral, limited, and the boundary was fuzzy. Pulmonary parenehymal disease was found in 11 eases, in which ground - glass opacities was central, limited , but the edge was clear. 1 l pa- tients were diagnosed with obstnwtive ventilatory dyslkmcti~,n, in which ground -glass opacities were peripheral and central in common, and more with fine mesh honeycomb lesions and small vessel thickening performa,we. Conclusion Puhnonary ground - glass opacities is common in interstitial lung disease, puhnonaLw parenchymal disease and obstructive disease. Ahhough it is not a specific sign, there are different ground - glass shadow signs in different lung diseases, and this will help narrow the diagnosis of clinical range.