MSCT对肺韦格氏肉芽肿诊断价值的临床评价

Clinical evaluation onthe diagnostic value of multi-slice CT in the diagnosis of pulmonary Wegener's granulomatosis

目的探讨MSCT对肺韦格氏肉芽肿的临床诊断价值。方法对我院2012年4月至2014年9月收治的24例肺韦格氏肉芽肿患者的临床资料进行回顾性分析,总结肺韦格氏肉芽肿患者的MSCT特征。结果 24例患者均有双肺多发结节影,大小不等,且2例患者结节周围见＂供养血管征＂。8例患者有多发结节合并肿块,肿块直径为3.0~6.5 cm,肿块内部可见空洞。8例患者为胸膜下楔形病灶,增强扫描呈边缘强化,并可见＂血管供给征＂。8例患者有磨玻璃征,肿块内可见边缘模糊的血管轮廓。6例患者支气管管壁增厚及扩张,2例患者伴有肺中叶肺不张,并有两侧少量胸腔积液。4例患者可见结节钙化。1例患者合并部分小结节影增大演变为肿块。结论肺韦格氏肉芽肿的MSCT特征常见的表现为多发结节伴＂血管供给征＂、结节毛刺、＂岛屿征＂和毛玻璃影等,对肺韦格氏肉芽肿的诊断具有一定的临床价值。

Objective To investigate the clinical diagnostic value of MSCT in the diagnosis of pulmonary Wegeners granulomatosis.Methods 24 cases with pulmonary Wegener’s granulomatosis in our hospital from April 2012 to September 2014 were selected for the study,the clinical datas of them were retrospectively analyzed to summarize the MSCT characteristics of the patients with lung Wegener’s granulomatosis.Results 24 patients had multiple nodular shadow of lung with varied size,and 2 patients showed ＂dependent vascular symptoms＂ around the nodules.8 patients had multiple nodules with lumps,and the diameters of the lumps were 3.0 to 6.5cm.Besides,tumor cavity inside was visible.8 cases of patients had wedge- shaped subpleurallesions.The results of enhanced scan showed marginalization and the entry of vascular shadow,which was called ＂ vascular support levy.＂ Eight patients had ground- glass sign,and edge blur of blood vessels within the tumor contour were visible.6 patients had thickening and expansion bronchial wall.2 cases of patients had pulmonary atelectasis in the middle of the lung,with a small amount of pleural effusion on both sides.The nodulars of 4 patients were calcified.Some small nodules of one patient evolved into mass lumps.Conclusions The common MSCT feature of pulmonary Wegeners granulomatosis were manifestations of multiple nodules with ＂ vascular supply ＂ sign,nodule glitch, ＂islands sign＂ and frosted glass film,etc,which shows the clinical value to the diagnosis of pulmonary Wegeners granulomatosis to some degree.