胶原血管病性肺病的薄层CT表现

A study on thin-section CT findings in pulmonary involvement in the collagen-vascular diseases

目的 探讨胶原血管病性肺病的薄层CT影像特征与病理相关性及用于鉴别诊断的价值。方法 对经临床及实验室证实的 8例类风湿性关节炎 (RA)、2例进行性多发性硬化 (PSS)、12例系统性红斑狼疮 (SLE)及1例Bechet病的胸部薄层CT(包括部分高分辨率CT)影像特征进行回顾性分析。观察内容包括蜂窝状影、索条状影、牵引性支气管扩张、磨玻璃密度、肺内结节、多发性肺实变、肺气肿、支气管血管束增粗、胸膜下结节、胸膜增厚、胸腔积液和胸膜钙化等。结果 (1)蜂窝状影、索条状影及牵引性支气管扩张为各类胶原血管性肺病的常见表现 ,以RA、PSS多见 ;(2 )肺内结节及胸膜下结节为RA的特征性表现 ;(3)多发性肺实变多为SLE特征性表现 ;(4)胸腔积液、胸膜增厚以SLE最多见 ;(5 )胸膜钙化及肺内少量钙化为PSS特征性表现。结论 根据薄层CT的影像表现特征 。

Objectives To find out the correlation of thin-section CT manifestations feature with pathological feature and the value of differential diagnosis in pulmonary involvement in the collagen diseases.Metheds Retrospective analysis has been made of 8 Rheumatoid Arthritis (RA),2 Progressive systemic sclerosis (Pss),12 Systemic lupus erytehematosus (SLE) and 1 Bechet's syndrome in lung thin-section CT features,all of them were proved by clinic and laboratory results.The following were recorded:(1) honeycombing , linear opacity , traction bronchiectasis ,ground-glass opacity, pulmonary nodule ,multi-pulmonary consolidation, emphysema, peribronchovascular interstitial thickening,subpleural nodule,pleural thickening pleurorrhea and pleural calcification ,et al. Results honeycombing,linear opacity and traction bronchietasis are the common appearances of all pulmonary collagen diseases , it is commonly seen in RA and Pss in this study.(2)pulmonary nodule and subpleural nodule are the characteristics findings in RA.(3) multi-pulmonary consolidation is majority feature in SLE. (4) pleurorrhea and pleural thickening are most commonly seen in SLE .(5) pleural calcification and internal-pulmonary calcification are the characteristic appearances of Pss.Conclusions According to thin-section CT manifestation features , it can use in the differential diagnosis in pulmonary involvement in the collagen diseases.