碎石路征—83例薄层CT表现

Study on the crazy-paving pattern: 83 cases of thin-section CT findings

目的:通过列举导致碎石路征表现各类疾病,比较其薄层CT的表现与组织病理学表现的关系。方法:回顾性的分析309医院放射科CT扫描数据库有关碎石路征报道的胸部薄层CT83例患者资料,对碎石路征表现的病例进行研究。结果:83例均表现为碎石路征的病例,包括感染35例(细菌感染6例,病毒性感染16例,真菌感染1例,混合感染12例);急性呼吸窘迫综合征(ARDS)4例;急性肺水肿3例;间质性肺疾病(UIP,NSIP)18例;腺癌3例;淋巴管癌病3例;淋巴瘤肺浸润2例;放射性肺炎5例;结节病1例;肺泡蛋白沉积症4例;肺泡出血4例;类脂性肺炎1例。结论:碎石路征是一种非特异性的薄层CT征象,可见于感染性、肿瘤性以及一些原因不明的疾病。如果缩小鉴别诊断范围,则可提示某种疾病的诊断。

Objective： The purpose of this paper is to illustrate different diseases that cause this crazy-paving pattern and to correlate the thin-section CT findings with the histopathological findings. Methods： A retrospective review of the medical records of our radiological computed tomography database was performed from January 2010 until December 2012,searching for patients reported to have a crazy-paving pattern on a thin-section CT of the chest. In total, 83 patients with a crazy-paving pattern were retained and reviewed. Results： The crazy-paving pattern consists of interlobular septal and intralobular interstitial thickening superimposed on an area of ground-glass attenuation on thin-section CT scans. We identified 83 cases that presented with the crazy-paving pattern, inclould infection（bacterial infection n=6,viral infection n= 16,fungal infection n=l,and mixed infection n=12）; ARDS n=4; acute pulmonary oedema n=3; interstitial lung disease （UIP, NSIP） n=18; adenocarcinomas n=3; lymphangitis carcinomatosis n=3; lymphoma pulmonary infiltration n=2; radiation pneumonitis n=5; sarcoidosis n= 1; alveolar proteinosis n=4; alveolar hemorrhage n=4; lipid pneumonia n=l. Conclusion： The crazy-paving pattern on thin-section CT is a non-specific signs, can be seen in infections, tumor, as well as some cryptogenetic diseases. Nevertheless, familiar with these common diseases, allows us to narrow the differential diagnosis, even prompted the diagnosis of certain diseases in the appropriate clinical setting.