高分辨CT在肺弥漫性结节诊断中的应用

Role of high resolution CT in diffuse pulmonary nodules

目的 探讨高分辨CT(HRCT)对肺弥漫性结节的诊断价值。方法 观察 5 0张正常胸片、常规CT以及HRCT对肺小叶的显示 ,对 38例肺弥漫性结节的结节形态、分布以及内部结构的HRCT表现进行分析。结果 胸片未能显示正常肺小叶结构 ,常规CT显示 2 0 % ,HRCT显示 5 0 % ,三者差异有显著性 (P <0 .0 5 )。 38例肺弥漫性结节中 ,间质结节 19例 ,位于肺间质内、小叶间隔和胸膜下 ,HRCT显示其沿支气管分布 ,结节边缘清楚 ;气腔结节 4例 ,病灶以气腔实变为主 ,胸膜下及小叶间隔无结节。HRCT显示其质地均匀 ,边缘模糊 ;随机分布结节 15例 ,结节呈随机分布 ,HRCT显示其一般密度较高 ,大小不一 ,边缘清楚。结论 HRCT能显示肺弥漫性结节的分布特点、结节内结构及背景 。

Objective To evaluate high resolution CT (HRCT) in the diagnosis of diffuse pulmonary nodules. Methods Fifty normal chest radiolographs, conventional CT and HRCT were used to evaluate the visualization of pulmonary lobule. The configuration, distribution and intrinsic structure of leison in 38 patients with diffuse pulmonary nodules were analyzed by HRCT. Results The chest radiolographs were not able to show the structure of pulmonary lobule. The visualization rates of pulmonary lobule were 20% by conventional CT and 50% by HRCT ( P <0.05). Of 38 patients with diffuse pulmonary nodules, 19 had interstitial nodules which were located in the pulmonary intestities, the lobular septa and beneath the pleura. HRCT could clearly show their para bronchial distribution with clear cut margin. Four had airspace nodules, chiefly shown as solidification of the air spaces. There was no nodule beneath the pleura or in the lobular septa. HRCT revealed even density and hazzy margins. Fifteen had randomly distributed nodules, with the nodules scattered irregularly. HRCT showed nodules with high density, sizes varying greatly but the margin was clear. Conclusion High resolution CT is able to show the pattern of distribution, intranodular structures and background of the diffuse pulmonary nodules, which is valuable in the diagnosis and differential diagnosis of this disease.