弥漫性间质性肺疾病的HRCT诊断及鉴别诊断价值

Diagnosis and Differential Diagnosis Value of High Resolution CT for Diffuse Interstitial Lung Disease

目的探讨高分辨率CT在弥漫性间质性肺疾病诊断及鉴别诊断中的应用价值。方法选取135例弥漫性间质性肺疾病,分析所有的高分辨率CT、普通CT以及胸部X线片的检查结果,比较三种检查方法的影像学表现阳性率。结果 HRCT检查弥漫性间质性肺疾病,早期影像表现网状阴影、小结节阴影、胸膜下磨玻璃影、网状结节影以及晚期表现蜂窝肺改变的阳性率分别为86.67%、66.67%、38.52%、41.48%和47.41%,高于CT检查所发现各影像学表现阳性率(44.44%、37.78%、17.78%、19.26%和22.96%),差异有统计学意义(P<0.05);同样也明显高于X线检查所发现各影像学表现阳性率(37.78%、22.22%、8.89%、10.37%和12.59%),差异有统计学意义(P<0.05)。结论高分辨率CT在弥漫性间质性肺疾病影像学表现的优势明显优于常规CT和X线检查,有助于提高诊断的准确性,减少漏诊和误诊。

Objective To discuss the diagnosis and differential diagnosis value of High resolution CT （HRCT） for interstitial lung disease. Methods Total 135 patients with diffuse imerstitial lung disease received high resolution CT, ordinary CT and chest X-ray examlnation, then the positive rate of imaging findings in the three groups were compared. Results The positive rate for reticular shadows, small nodular shadows, ground-glass opacities at subpleural area, both nodular and reticular opacities and honeycombing（late manifestation） by HRCT were 86.67% ,66.67% ,38.52% ,41.48% and 47.41%, respectively;by ordinary CT were 44-. 44% ,37.78% , 17.78% , 19.26% and 22.96% , respectively ; by X-ray were 37.78% , 22.22% , 8.89% , 10.37% and 12.59 % respectively ; the difference among the three groups were statistical significance （ P 〈 0.05 ）. Conclusion The accu- racy rating of HtlCT for interstitial lung disease is obviously higher than conventional CT and X-ray, and this improve the diagnos- tic accuracy and reduce misdiagnosis and missed diagnosis.