肺间质性疾病的HRCT表现及相关病理研究

HRCT appearances and associated pathological study of interstitial lung diseases

目的 :分析肺间质性疾病的HRCT表现及其与病理学的关系。方法 :3 8例经手术病理证实的肺间质纤维化患者和疾病对照组 14例分别行HRCT扫描、组织病理学检查 (包括HE、Masson氏三色染色 )及免疫组化。结果 :早期组中肺小叶间隔增厚 81.2 5 % ,肺内渗出毛玻璃影 18.75 % ,肺内小结节影 66.67% ,胸膜下曲线 12 .5 % ;中、晚期组中肺小叶间隔纡曲、僵直、变形 85 .71% ,支气管血管束纡曲、僵直 3 5 .71% ,范围较广的肺气肿 3 2 .14 % ,蜂窝肺 2 8.5 7% ,胸膜增厚3 9.2 9%。结论 :HRCT是一种安全、反映准确、无创性的诊断ILD的手段 ,经与病理对照 ,毛玻璃影、小叶间隔增厚、肺内小结节影、网状影和胸膜下曲线是ILD早期征象 ;而肺小叶间隔纡曲、僵直、变形 ,支气管血管束纡曲、僵直 ,范围较广的肺气肿及蜂窝肺是中。

Objective:To analyze the HRCT appearances of interstitial lung diseases (ILD).Methods:38 cases with pathologically proved ILD and 14 cases of control group were performed HRCT scanning,histological and immunohistochemistry examinations.Histological examinations included HE staining and Masson's trichrome staining.Results:Early stage interstitial lung diseases had the following HRCT findings:interlobular septal thickening (81.25%),ground glass opacity(18.75%),tiny nodular shadow(66.67%),and subpleural curved lines(12.5%).On the other hand,median and late stage had the following HRCT findings:twisting,rigidity and irregularity of interlobular septa (85.71%) and bronchovascular bundles(35.71%),emphysema (32.14%),honeycombing (28.57%) and pleural thickening (39.29%).Conclusion:HRCT is a safe,sensitive and non invasive method in the diagnosis of ILD.The HRCT features are well correlated with the pathological findings.