原发性肺淋巴管扩张症的CT及CT淋巴管成像表现

CT and CT Lymphangiography Findings of Congenital Pulmonary Lymphangiectasis

目的:探讨胸部CT及CT淋巴管成像(CTL)在原发性肺淋巴管扩张症(CPL)的诊断价值。材料及方法:回顾性分析2012年8月至2021年7月41例经临床及影像确诊为CPL患者的临床及影像学资料,所有患者均于直接淋巴管造影术(DLG)前行胸部CT检查,并于DLG后行CTL检查,分析胸部CT及CTL图像,所得结果采用分类变量资料中的构成比进行统计描述。结果:41例患者中胸部CT表现为支气管血管束增粗33例,小叶间隔增厚32例,小叶内间质增厚4例,磨玻璃密度影26例,肺实变5例,肺不张14例,胸腔积液24例。CTL碘油异常沉积于胸导管末端35例,支气管血管束31例,肺门32例,胸膜17例,纵膈36例,心包17例,横膈3例,腹腔内10例,腹膜后10例,盆腔及会阴20例。结论:CT和CTL可显示淋巴管异常的范围及分布,为CPL诊断和治疗提供影像学依据。

Objective: To investigate the diagnostic value of chest CT and CT lymphangiography(CTL) in congenital pulmonary lymphangiectasia(CPL). Materials and methods: The clinical and imaging datas of 41patients with CPL diagnosed by clinical and imaging from August 2012 to July 2021 were retrospectively analyzed. All patients underwent chest CT examination before direct lymphangiography(DLG) and CTL after DLG. The CT and CTL imaging manifestations were analyzed and statistically described using the composition ratio in the categorical variable data. Results: Among the 41 patients, CT showed thickening of bronchovascular bundles in 33 cases, interlobular septal thickening in 32 cases, intralobular interstitial thickening in 4 cases, and ground-glass opacity in 26 cases, 5 cases of lung consolidation, 14 cases of atelectasis, 24 cases of pleural effusion.CTL lipiodol was abnormally deposited at the end of the thoracic duct in 35 cases, bronchovascular bundles in 31cases, hilum in 32 cases, pleura in 17 cases, mediastinum in 36 cases, pericardium in 17 cases, diaphragm in 3cases, intraperitoneal in 10 cases, and retroperitoneal in 10 cases, 20 cases of pelvis and perineum. Conclusion: CT and CTL can show the extent and distribution of Lymphangiectasia, and provide imaging basis for the diagnosis and treatment of CPL.