高分辨率CT在乳腺癌放疗后放射性肺炎早期诊断中的应用

HRCT of radiation pneumonitis in breast cancer

目的探讨乳腺癌放疗后放射性肺炎早期的高分辨率CT(HRCT)征象及其临床应用价值。方法回顾分析31例乳腺癌患者放疗前后的肺部CT及HRCT征象。结果 18例患者在早期胸部HRCT出现影像学改变,表现为照射野内毛玻璃样改变,支气管血管束增粗,小叶间隔增厚目的,斑片状致密影,其内见支气管充气征;在9例同时出现毛玻璃样改变、支气管血管束增粗及小叶间隔增厚3种征象的患者中,有7例3月后发展为放射性肺炎,占78%(7/9)。结论照射野毛玻璃样改变、支气管血管束增粗及小叶间隔增厚是早期放射性肺炎的重要HRCT征象,患者早期同时出现这几种HRCT表现,往往提示放射性肺炎的发生。

Objective To assess the high-resolution computed tomography （HRCT） features of radiation pneumonitis in patients with breast cancer. Methods HRCT of 31 patients with pneumonitis after radiation treatment of breast cancer was analyzed retrospectively. Results HRCT showed ground-glass opacities, enlargement of bronchovascular bundles, and thickening of the interlobular septa in the radiation field of 9 patients. Seven of these nine patients developed radiation pneumonitis 3 months later. Conclusions Ground-glass opacity, enlargement of bronchovascular bundles and thickening of interlobular septa are early HRCT features of radiation pneumonitis.