肺泡蛋白沉积症的CT诊断

CT diagnosis of pulmonary alveolar proteinosis

目的 :探讨肺泡蛋白沉积症的CT表现和诊断价值。方法 :4例均有完整的临床、实验室以及胸片和高分辨率CT(HRCT)检查资料 ,4例均经肺泡灌洗术 ,其中 3例经纤支镜检、1例经肺穿刺活检病理证实。对其CT表现进行回顾性分析。结果 :本病在HRCT象上呈多样化改变 :从弥散分布的较模糊的结节影到弥漫性斑片状云雾状肺实变阴影与磨玻璃影 ,呈地图样分布 ;多见蜂窝状、网状间质性表现 ,同时伴有病变范围内光滑的小叶间隔增厚。结论 :临床表现、实验室检查、影象学检查特别是HRCT表现相结合并综合分析 ,可明确诊断 ,并不一定完全依赖于纤支镜或肺穿刺活检来确诊。

Objective:To study the CT findings of pulmonary alveolar proteinosis (PAP).Methods:The CT findings of 4 cases were retrospectively analysed,of which 3 cases were histologically proved by fiberoptic bronchoscopy and 1 case by lung puncture biopsy.All the 4 cases were performed bronchoalveolar lavage.Results:On HRCT there were a variety of findings of PAP as following:(1) From diffuse,vague nodular shadows to diffuse patchy cloudy shadows and ground glass appearance.(2) Honeycomb like appearance and interstitiel changes with smooth thickening of interlobular septums within the lesion.Conclusion:HRCT findings may help in diagnosis of PAP,especially coupled with clinical data and labortory tests,not completely dependent on fiberoptic bronchoscopy and lung puncture biopsy.