高分辨率CT诊断普通间质性肺炎伴纵隔淋巴结肿大的应用研究

High resolution CT in the diagnosis of usual interstitial pneumonia with mediastinal enlargement of lymph nodes

目的通过高分辨率CT探索普通间质性肺炎伴纵隔淋巴结肿大影像学特征及解剖分布规律,分析普通间质性肺炎患者纵隔淋巴结肿大的特点,为临床诊断和处理提供依据。方法回顾性分析我院收治的149例(男71例,女78例)普通间质性肺炎患者的高分辨率CT影像信息,结合多平面重组MPR图像后处理重建,横断位上测量纵膈淋巴结短径,并根据国际癌症协会胸部淋巴结分区法记录纵膈淋巴结肿大分布情况。结果普通间质性肺炎患者140例中伴纵隔淋巴结肿大81例,发生率为54.36%,其中男性49例(60.49%)、女性32例(39.50%)合并纵膈淋巴结肿大,男性发生率高于女性(P<0.05)。共记录212枚淋巴结肿大,纵膈淋巴结肿大最大短径平均为(13.02±2.68)mm,纵隔淋巴结肿大优势解剖分布依次为4R组95枚(44.81%)、4L组31枚(14.62%),6组21枚(9.90%)、7组17枚(8.02%)、2组12枚(5.66%),各组之间比较,P均<0.05。结论普通间质性肺炎患者伴发纵隔淋巴结肿大的比例较高,高分辨率CT观察到明显影像学特征和优势解剖分布规律,对临床鉴别诊断具有重要价值和意义。

Objective To explore the imaging characteristics and anatomical distribution characteristics of usual interstitial pneumonia with mediastinal enlarged lymph nodes by high resolution CT,analyze the characteristics of mediastinal enlarged lymph nodes to provide basis for clinical diagnosis and treatment.Methods The high resolution CT image information of 149 patients(71 male,78 female)with common interstitial pneumonia in our hospital was retrospectively analyzed.The distribution of mediastinal enlarged lymph nodes was recorded combined with image post-processing and reconstruction of multiple planar reconstructio(MPR),the short diameter of mediastinal lymph nodes in transverse view,and the International Cancer Society thoracic lymph node partition method.Results There were 81 cases of usual interstitial pneumonia with mediastinal enlargement of lymph nodes,the incidence was 54.36%,among which 49 cases were male(60.49%)and 32 cases were female(39.50%).The comparison of the incidence between male and female was with P<0.05.A total of 212 enlarged lymph nodes were recorded,and the average short axis of lymph nodes was(13.02±2.68)mm.For the distribution of mediastinal enlarged lymph nodes,there were 95(44.81%)in the 4R group,31(14.62%)in the 4L group,21(9.90%)in the 6 group,17(8.02%)in the 7 group,12(5.66%)in the two groups(all P<0.05).Conclusion Usual interstitial pneumonia patients have a high proportion in mediastinal enlargement of lymph nodes.High resolution CT can observe obvious imaging characteristics and advantages in anatomical distribution,which is of great significance for clinical diagnosis.