限局性机化性肺炎影像学诊断的探讨(附29例分析)

Imaging Diagnosis of Localized Organizing Pneumonia

目的 探讨限局性机化性肺炎的影像学诊断。方法 回顾性分析 2 9例病理组织学证实为限局性机化性肺炎的临床、CT资料。结果 2 9例中 2 7例 (93 % )病灶邻近胸膜 (包括纵隔胸膜 ) ,病灶大小在 2～ 4cm之间 ,中心层面呈圆形或类圆形 13例 (4 5 % ) ,不规则形 16例 (5 5 % ) ;边缘显示毛刺 18例 (62 % ) ;纵隔窗上边缘或大部分边缘呈向心性弓形凹陷 ,且相邻边缘交界处呈尖角状突起 2 0例 (69% ) ;邻近肺野不同程度的渗出性病变 12例 (4 1% ) ;可见支气管血管束聚拢 8例(2 7% ) ;有邻近胸膜轻度粘连、肥厚或胸膜凹陷 13例 (4 4 % )。结论 CT ,特别是高分辨率CT可显示限局性机化性肺炎某些特征 ,大部分病例可作出诊断 ,部分病例可行CT导引下穿刺活检作出诊断。

Objective To evaluate the diagnostic value of CT for the localized organizing pneumonia (LOP). Methods The clinical and CT findings of 29 cases of LOP proved histologically were analyzed retrospectively. Results The size of 27 lesions varied from 2 to 4cm in diameter,and they were near the pleural surface (including the mediastinal pleura).The lesions were detected as round in 13 cases and irregular in 16 cases.There were inward bow indentations in 20 cases (69%).The infiltrating lesions in surrounding structures were found in 12 cases and bronchovascular bunches were in 8 cases.The near pleural thickening,adhesion or pleural hollow was found in 13 cases. Conclusion CT,especially HRCT appearance of LOP can show some features that make most of them to be diagnosed,and some of them need to be biopsied percutaneouslly.