132例结缔组织病相关间质性肺病的影像学分析

Imaging analysis of 132 cases of connective tissue-related interstitial lung disease

目的:探讨132例结缔组织病相关间质性肺病(CTD-ILD)的高分辨CT(HRCT)的影像学特点。方法:回顾性分析2015年1月至2020年1月,本院132例CTD-ILD患者的临床资料,均经临床实验室检查或病理学检查确诊为结缔组织病(CTD),且HRCT证实存在肺间质病变(ILD),回顾性分析患者HRCT表现特点。结果:132例患者HRCT表现分类中,非特异性间质性肺炎(NSIP)、普通型间质性肺炎(UIP)、机化性肺炎(COP)、淋巴细胞间质性肺炎(LIP)及其他占比分别为36.4%、31.8%、15.9%、3.0%、12.9%;NSIP、UIP占比高于COP、LIP及其他,差异有统计学意义(P<0.05);132例患者HRCT表现中,胸膜下间质病变累及、小叶内间质增厚、磨玻璃影占比较高,分别为96.2%、77.3%、75.8%;类风湿性关节炎合并间质性肺病实变率高于其他疾病类型(P<0.05);皮肌炎/多发性肌炎合并间质性肺病蜂窝率高于其他疾病类型(P<0.05);系统性红斑狼疮合并间质性肺病胸膜下累及率低于其他疾病类型(P<0.05);原发干燥综合征合并间质性肺病食管扩张率高于其他疾病类型(P<0.05)。结论:CTD-ILD中HRCT诊断价值较高,表现多见胸膜下间质病变累及、小叶内间质增厚、磨玻璃影等。

Objective:To investigate the imaging features of high resolution CT(HRCT)in 132 cases of connective tissue disease-related interstitial lung disease(CTD-ILD).Methods:The clinical data of 132 patients with CTD-ILD in our hospital from January 2015 to January 2020 were retrospectively analyzed.All patients were diagnosed as CTD by clinical laboratory examination or pathological examination,and HRCT confirmed the presence of interstitial lung disease(ILD).Results:Among the 132 patients,non-specific interstitial pneumonia(NSIP),common interstitial pneumonia(UIP),COP,lymphocyte interstitial pneumonia(LIP)and others accounted for 36.4%,31.8%,15.9%,3.0%and 12.9%,respectively.The proportion of NSIP and UIP was higher than COP,LIP and others,and the difference was statistically significant(P<0.05);The HRCT findings of 132 patients showed that subpleural interstitial lesions,interlobular interstitial thickening,and ground glass shadows accounted for 96.2%,77.3%,and 75.8%,respectively.Rheumatoid arthritis with interstitial lung disease has a higher consolidation rate than other disease types(P<0.05);The cellulite rate of dermatomyositis/polymyositis with interstitial lung disease was higher than that of other disease types(P<0.05);The subpleural involvement rate of systemic lupus erythematosus with interstitial lung disease was lower than that of other disease types(P<0.05);Primary Sjogren′s syndrome combined with interstitial lung disease has a higher rate of esophageal dilatation than other disease types(P<0.05).Conclusions:HRCT has a high diagnostic value in CTD-ILD,and most of the patients have subpleural interstitial lesions,interlobular interstitial thickening,and ground glass shadows.