韦格纳肉芽肿病肺部损害的影像分析  

Imaging Analysis on Pulmonary Wegener's Granulomatosis

作　　者：冯仕庭[1] 陈境弟[1] 李子平[1] 周旭辉[1] 孙灿辉[1] 范淼[1] 彭振鹏[1] 

机构地区：[1]广州中山大学附属第一医院放射科,广州510080

出　　处：《放射学实践》2008年第2期138-140,共3页Radiologic Practice

摘　　要：目的：探讨韦格纳肉芽肿痛肺部影像学表现，提高对该痛的诊断水平。方法：总结分析经病理证实的韦格纳肉芽肿27例肺部影像表现，男17例，女10例，年龄13～68岁，平均34．5岁。其中胸片27例，胸部CT平扫加增强扫描15例。结果：27例中肺部有异常表现19例，占70．4％。异常表现有大片状浸润痛灶5例，小片状浸润痛灶4例，多发结节影（直径小于3cm）9例，肿块（直径大于3cm）2例，空洞11例，条状阴影4例，磨玻璃影3例，肺不张2例，支气管狭窄阻塞2例。13例多种痛灶混合存在，并互相转化，痛灶增多或减少。结论：韦格纳肉芽肿痛肺部异常表现呈多样性，以片状浸润、结节和空洞病变最常见，薄壁空洞和环形空洞具特征性。此病要与肺癌、结核、肺炎与脓肿等疾病相鉴别。Objective：To study the imaging features and so as to improve the diagnostic accuracy of pulmonary Wegener＇s granulomatosis. Methods：Twenty-seven patients,17 males and 10 females,aged 13～68 （mean 34.5 yrs） with histopathologically and clinically proved Wegener＇s granulomatosis were included. Chest radiographic examination was performed in all the 27 patients and CT chest examination was undergone in 15 of them. Results： Pulmonary abnormalities were presented in 19 of the 27 patients （70.4%）. Massive patches of infiltration with blurred margins （n= 5） ,small patchy infiltration （n= 4） ,multiple nodules （less than 3cm in diameter, n= 9）, masses （more than 3cm in diameter, n= 2）, cavitations （ n= 11）, stripe shadows （ n = 4）, ground-glass like shadows （ n = 3）, signs of pulmonary atelectasis （ n = 2） and bronchus narrowing or obstruction （n= 2） were included in the imaging manifestations of these cases of pulmonary Wegener＇s granulomatosis. Coexistence of multiple sorts of lesions which changed from one to another, from increase to decrease in numbers was observed in 13 of the cases. Conclusion：The imaging manifestations of pulmonary Wegener＇s granulomatosis were miscellaneous; patchy infiltrations, nodules and cavitations of the lungs were the imaging signs most frequently found. Signs of cavities with thin and/or ring-shaped walls were diagnostically specific. Pulmonary carcinoma,tuberculosis, pneumonia and abscesses should be excluded before the diagnosis of this disease was established.

关 键 词：韦格纳肉芽肿痛 体层摄影术 X线计算机 放射摄影术 

分 类 号：R593.9[医药卫生—内科学] R816.4[医药卫生—临床医学]