系统性硬化症肺部高分辨率CT表现

HRCT of the lung in systemic sclerosis

目的 提高对系统性硬化症(SSc)肺部高分辨率CT(HRCT)表现的认识。方法 回顾性分析62例SSc肺部HRCT表现,并对其中的12例随访病例进行动态观察。结果 11例肺基本正常,51例均表现为不同程度的肺间质纤维化。HRCT表现:(1)小叶间隔增厚(23例,45.1％);(2)胸膜下弧形线(8例,15.7％);(3)磨玻璃密度影(19例,37.3％);(4)网格样影(13例,25.5％);(5)囊状影(9例,17.6％);(6)支气管血管束增粗(6例,11.8％);(7)蜂窝征(19例,37.3％);(8)胸膜下小结节(3例,5.9％)。上述征象大多先后出现,并以两肺外围分布为主。12例随访病例中,2例CT征象消失,7倒无明显变化,3例进展为蜂窝肺。结论 SSc肺部HRCT主要表现为以两肺外围分布为主的间质性纤维化。磨玻璃密度影及胸膜下弧形线是病变的早期表现,蜂窝肺为其结局。

Objective To improve the recongnization for HRCT appearance of systemic sclerosis(SSc). Methods HRCT images of sixty - two cases with SSc were retrospectively analysed, and 12 cases were followed up for 6 months to 3 years after treatment with penicillin plus corti-coid. Results 51 cases of 62 patients(82.3%) were showed pulmonary interstitial diseases in different degree. HRCT features as following: (1) Interlobular septal thickening(23 cases, 45.1%). (2) Parallel subpleural lines(8cases,15.7%) . (3)Ground glass opacity (19cases,37.3%) . (4) Reticular pattern(13cases, 25.5%) . (5)Cystic attenuation (9cases, 17.6%) . (6)Bronchovascular thickening(6cases, 11.8%) . (7) honeycomb pattern (19cases, 37.3%). (8) Subpleural micronedes(3cases, 5.9%). Most of them were located peripherally and appeared in different time. Of the 12 cases with follow- up, 2 cases recovered normal, 7 had no change and 3 progressed to honeycombed lung. Conclusion The common appearance of SSc are Interlobular septal thickening, groud glass opacity and honeycomb pattern on HRCT, most of which locate peripherally. Ground glass opacity and parallel subpleural lines are preliminary features of SSc, and honeycombed lung is finale.