肺泡微石症的影像学诊断

Imaging diagnosis of pulmonary alveolar microlithiasis

目的 :探讨肺泡微石症的影像学特征。方法 :报道肺泡微石症 6例 ,全部病例均行胸部X线检查 ,2例行常规CT ,1例行HRCT。并对全部影像学表现进行了回顾性分析。结果 :6例胸片表现为弥漫粟粒样微细结节 (2例 )。“鱼子样”或“暴风沙样”(2例 )、“白肺样”(1例 )及高密度“面纱样”改变 (1例 )。CT可明确肺内微细结节的钙化密度、肺尖部气肿样改变及支气管血管束增粗并呈钙化密度。HRCT则可进一步显示肺野磨砂玻璃样改变 ,小叶间隔、叶间胸膜及支气管血管束钙化密度与串珠状增厚 ,小叶中心分布的微细结节与胸膜下蜂窝。结论 :肺泡微石症是一种罕见病 ,其影像学表现具有特征性 。

Objective:To explore the imaging features of pulmonary alveolar microlithiasis (PAM).Methods:6 cases of PAM were performed chest radiography,while additional CT scans and high resolution CT (HRCT) were done in two and one case respectively.All imaging findings were retrospectively analyzed.Results:Plain radiographs of PAM of 6 cases showed diffuse fine micronodulation (n=2),'fish eggs like' or 'sandlike'(n=2),'white lung like'(n=1) and high dense 'mask like'appearance(n=1).CT could show fine micronodular calcifications in the lung and along the bronchovascular bundles,emphysema or blebs and bullae developed in the lung apices and peribronchovascular interstitial thickening.HRCT could further document the ground glass opacity in the lung,thickened interlobular septa or pleura or beaded septal thickening as well as calcifications along the bronchovascular bundles. And the fine micronodulation in the center of the louble and subpleural honeycomb shadows were also shown on HRCT.Conclusion:PAM is a rare disease which has imaging features while imaging methods are the key to accurately diagnose the disease, particularly HRCT.