肺泡蛋白沉积症的X线、CT诊断

X-ray and CT Diagnosis of Pulmonary Alveolar Proteinosis

目的 :总结肺泡蛋白沉积症 (PulmonaryAlveolarProteinosisPAP)的X线、CT影像学特征。材料与方法 :报道经支纤镜活检及肺泡灌洗术证实的肺泡蛋白沉积症 5例 ,复习文献资料 ,对PAP的X线、CT表现进行综合分析 ,并探讨其诊断和鉴别诊断。结果 :该病X线表现 :两肺对称或不对称分布磨玻璃样阴影 ,自肺门向外放射呈“蝶翼征” ;其中可见弥漫结节样阴影。CT表现 :1、双肺弥漫性斑片状阴影与磨玻璃样改变 ,病灶与正常肺组织间分界清楚 ,呈地图样分布。 2、蝶翼征。3、支气管充气征。 4、铺路石征 (Crazy-Pavingsign)。结论 :肺泡蛋白沉积症具有上述典型的X线、CT表现 ,结合临床病史综合分析可作出诊断 。

Purpose:To analysis X-ray and CT feature of pulmonary alveolar proteinosis(PAP).Materials and Methods:Report five cases with PAP which were proved by fiberoptic bronchoscopy and bronchoalveolar lavage,review literature,the X-ray?CT feature were analyzed.diagnosis and distinguish were discussed.Results:X-ray finding of the PAP:Symmetry or dissymmetry ground glass shadows and diffuse nodule appearance were distributed on two lungs.Radiation from hila to side,formed butterfly sign.CT feature:①Diffuse patchyshadows and ground glass appearance,distributed geographically,dividing line is clearly.②Butterfly sign.③Air-brochogram sign.④Crazy-Paving sign.Conclusion:there are typical feature of X-ray and CT for PAP,taking the clinical history into consideration together,a reliable diagnosis can be made,the diagnosis in conclusion are bronchoscopy of TNB.