肺泡蛋白沉积症所致铺路石征的CT表现及病理基础研究(英文)

Crazy paving pattern caused by pulmonary alveolar proteinosis: CT findings and the pathologic basis

目的:探讨肺泡蛋白沉积症所致铺路石征的CT表现及其病理学基础。方法:回顾性分析2006年6月至2012年5月经支气管镜肺活检和支气管肺泡灌洗液病理确诊为肺泡蛋白沉积症的24例患者的CT和病理表现,所有患者均行64层肺部CT。结果:特征性CT表现:CT影像上所有24例均可见铺路石征;23例铺路石征的部分边缘以光滑条状影为界、与周围正常肺组织分界清楚,条状影与周围血管相连、逐渐分支交织成不同大小的网状影。光学显微镜下:17例可见血管扩张、充血。结论:肺泡蛋白沉积症所致铺路石征常常有清楚的边缘、形成光滑的网状影,主要是由于肺泡、腺泡、小叶间的血管扩张所致,对诊断肺泡蛋白沉积症较有特异性。

Objective: To explore CT findings and pathologic basis of crazy paving pattern caused by pulmonary alveolar proteinosis.Methods: Twenty-four patients who were diagnosed pathologically as pulmonary alveolar proteinosis by transbronchial lung biopsy and bronchoalveolar lavage fluid from June 2006 to May 2012 were included in this retrospective study. All patients underwent a 64-slice CT of the lungs.Results: CT findings: crazy paving pattern was observed on CT imaging of all 24 patients. In 23 patients, crazy paving pattern displayed strip-shaped opacities with smooth edges, and there was a clear boundary between the pathological and normal lung tissues. The reticular opacities were connected with peripheral blood vessels and the branches were formed, and their diameters decreased slightly. Microscopically, hemangiectasis were seen in 17 patients.Conclusion: Crazy paving pattern caused by pulmonary alveolar proteinosis displayed clear edges, and smooth reticular opacities, most of which were due to hemangiectasis of interlobular, interacinar and interalveolar septa. These findings of CT are helpful for the specific diagnosis of pulmonary alveolar proteinosis.