161例胸椎骨赘相关性肺异常改变的CT特征分析

CT features of pulmonary abnormalities related to the osteophyte of thoracic vertebrae:an analysis of 161 cases

目的:探讨胸椎骨赘引起肺部异常改变的CT表现。方法:回顾性调阅2014年1月-2015年12月本院胸部CT体检2145例,检出胸椎骨赘旁肺部异常改变,记录肺部异常改变的部位、形态、大小及骨赘出现的部位、数目、最大骨赘的椎体及厚度,对多次体检的病例肺部异常改变进行随访观察。结果:2145例体检者中,检出胸椎骨赘旁肺部异常改变161例(7.51%),多发生于T 7~T 11水平,其中男性发生率为7.44%(83/1115),女性发生率为7.57%(78/1030),两组间差异无统计学意义(P=0.935)。年龄>50岁发生率14.24%(123/864),年龄≤50岁发生率2.97%(38/1281),两组间差异有统计学意义(P=0.000)。肺部异常阴影水平范围平均(17.65±7.75)mm(4.73~53.12 mm),垂直范围平均(41.98±29.37)mm(4.00~140.00 mm)。肺部异常区垂直范围与有骨赘椎体数目无相关性(P=0.383)。肺部异常区水平及垂直范围与骨赘厚度呈正相关(P=0.000及0.032)。随访病例中56例肺部阴影无变化,45例发生变化。结论:胸椎骨赘相关性肺异常表现为胸椎骨赘旁的磨玻璃影、线状影、网状影或混合阴影,随年龄的增加发生率增高,病灶范围与骨赘严重程度正相关,临床工作中应避免误诊为肺炎或间质纤维化等其它病变。

Objective:To investigate the CT features of pulmonary abnormalities related to the osteophyte of thoracic vertebra.Methods:The chest screen CT of 2145 individuals between January 2014 and December 2015 were retrospectively reviewed to evaluate the pulmonary abnormalities adjacent to the thoracic vertebra osteophytes in the study.The location,pattern,size of the pulmonary abnormalities as well as the location,number of the osteophyte,the thoracic vertebra and the thickness of the largest osteophyte were recorded.The change of the abnormalities during follow-up screening CT were evaluated.Results:Among the 2145 cases,161 patients(7.51%)presented pulmonary abnormalities adjacent to the thoracic vertebra osteophytes.The abnormalities mostly located at T 7-T 11 level.There was no significant difference between male(83/1115,7.44%)and female(78/1030,7.57%)(P=0.935).The incidence in people older than 50 years(123/864,14.24%)was significantly higher than those younger than 50 years(38/1281,2.97%)(P=0.000).The mean horizontal range and mean vertical rang of the abnormalities were(17.65±7.75)mm(4.73~53.12mm)and(41.98±29.37)mm(4.00~140.00mm)respectively.There was no correlation between the mean vertical rang of the abnormalities and the numbers of osteophyte,while the mean horizontal range and mean vertical rang of the abnormalities were positively correlated with the thickness of osteophyte(P=0.000 and 0.032).No changes were presented in 56 individuals,while changes were found in 45 individuals during follow-up.Conclusion:The pulmonary abnormalities related to the osteophyte of thoracic vertebrae appear as ground glass opacity,linear,reticular opacity or mixed pattern.The incidence of the abnormalities increases with age.The extent of the lesion is positively correlated with the severity of osteophyte.The abnormalities related to the osteophyte of thoracic vertebrae should not be misdiagnosed as pneumonia,lung fibrosis or other lung diseases.