胸部结节病的多排螺旋CT表现

The Multi Row Spiral CT Features of Thoracic Sarcoidosis

目的探讨胸部结节病(sarcoidosis)的多排螺旋CT表现,旨在提高对该病的认识及诊断水平。方法回顾性分析经病理或临床随访证实的36例胸部结节病患者的CT和临床资料。结果 36例结节病患者中,仅肺门及纵隔淋巴结肿大者6例,肺门及纵隔淋巴结肿大并肺内浸润者25例,仅见肺内浸润无淋巴结肿大者5例;肺内表现:肺内小结节沿支气管血管束及胸膜下分布者19例,小叶间隔不规则增厚者16例,实变影17例,"磨玻璃影"3例,蜂窝变10例。淋巴结表现:双肺门、上纵隔右下气管旁、气管隆突下分布多见,平扫CT值均匀,增强扫描呈中度以上明显强化。结论双侧肺门淋巴结对称性肿大和/或纵隔淋巴结肿大,以及沿支气管血管束分布的不规则结节影是肺部结节病特征性影像学表现,多平面重组(MPR)图像对该病的诊断有较高的价值。

Objective To analyze the multi row spiral CT features of thoracic sarcoidosis,and raise the level of awareness and diagnosis of this disease.Methods The CT and clinical data of 36 patients with thoracic sarcoidosis proved by pathology and clinical follow-up were retrospectively analyzed.Results Among the 36 cases,only the pulmonary hilar and mediastinal lymph node enlargement in 6 cases,pulmonary hilar and mediastinal lymph node enlargement and pulmonary infiltration in 25 cases,only pulmonary infiltrates without enlarged lymph nodes in 5 cases;intrapulmonary performance： small lung nodules along the bronchovascular bundle and subpleural distribution in 19 cases,interlobular septal thickening in 16 cases,real variable shadow in 17 cases,ground glass opacity in 3 cases,cellular change in 10 cases.Performance of lymph nodes： double hilar,the lung-right next to the trachea in the superior mediastinum,and tracheal carina distribution were more common.CT values in plain CT scan was uniform,significantly strengthened in enhanced CT scan.Conclusion The characteristic imaging features of pulmonary sarcoidosis is symmetrical enlargement of bilateral hilar lymph node,enlargement of mediastinal lymphadenopathy,and the irregular nodules shadows along the bronchovascular bundle distribution.Multiplanar reconstruction image（MPR）is of high clinical value.