肺淋巴管肌瘤病临床及HRCT诊断价值(附7例分析)

Clinical and HRCT diagnostic value of pulmonary lymphangiomyomatosis

目的分析肺淋巴管肌瘤病的胸片、MSCT和HRCT的表现,探讨HRCT的诊断价值。方法回顾性分析7例经病理证实并有完整资料的肺淋巴管肌瘤病患者的胸部X线、MSCT及HRCT表现。结果胸片诊断PLAM的价值有限,仅1例患者表现自发性气胸,1例考虑少量胸腔积液。MSCT 7例全肺密度减低,5例表现两肺散在分布囊状透光区,囊壁显示欠清,3例伴有细网格状改变,2例气胸,1例发现少量胸腔积液。HRCT:7例均可见两肺野内散在弥漫分布的、大小形状不一的囊状薄壁透光区,囊壁清晰,囊腔直径大部分小1cm,其中有有1例并呈蜂窝状改变。2例气胸,1例发现少量胸腔积液。结论MSCT可显示淋巴管肌瘤病部分肺部改变,而HRCT具有较特征性的表现,对PLAM的早期诊断及鉴别诊断具有重要参考价值,也是判断PLAM进展及预后、的有效指标。

Objective To analyze the chest X-ray, MSCT and HRCT findings of pulmonary lymphangiomyomatosis, and to explore the diagnostic value of HRCT. Methods The chest X-ray, MSCT and HRCT findings of 7 patients with pulmonary lymphangiomyomatosis were retrospectively analyzed. Results The value of chest radiography in the diagnosis of PLAM was limited. Only1 patient presented spontaneous pneumothorax and 1 patient considered a small amount of pleural effusion. MSCT decreased the density of the whole lung in 7 patients, 5 patients presented scattered two lungs in the cystic light transmittance zone, and the cystic wall was not clear, 3 patients were accompanied by fine mesh, 2 were pneumothorax, and 1 was found to have a small amount of pleural effusion. HRCT:in all 7 cases, diffuse cystic thin-walled light transmission areas with different sizes and shapes were scattered in the two lung fields. The cyst wall was clear and most of the cyst cavity diameter was small by 1 cm, of which 1 case presented honeycomb changes. Pneumothorax was found in 2 cases and pleural effusion was found in 1 case. Conclusion MSCT can show partial pulmonary changes in lymphangiomyomatosis, while HRCT has relatively characteristic manifestations, which is of important reference value for the early diagnosis and differential diagnosis of PLAM, and also an effective indicator for the judgment of PLAM progress and prognosis.