肺泡微石症的平片与CT对照研究  

Radiological and CT Correlative Study of Pulmonary Alveolar Microlithiasis

作　　者：全昌斌[1,2] 贾树林[1,2] 何宝明[1,2] 马大庆 姚光大 敖国昆[1,2] 

机构地区：[1]中国人民解放军309医院放射科 [2]北京友谊医院放射科

出　　处：《临床放射学杂志》1998年第4期208-211,共4页Journal of Clinical Radiology

摘　　要：目的：探讨肺泡微石症的平片与ＣＴ表现、成像机制及诊断价值。材料与方法：回顾性分析４例（男女各２例，年龄２１～３２岁）经活检病理证实或临床综合诊断的肺泡微石症平片与ＣＴ表现。结果：Ｘ线表现：４例平片均显示两肺有弥漫分布的细砂粒状微结节，其中３例中下肺野偏多，２例心包及横膈轮廓不清，２例有所谓的叶间裂增厚及心包钙化影，１例舌叶实变。ＣＴ表现：肺窗示肺实质内有无数细小的粟粒结节，多在胸膜下密集融合，３例并局限性肺气肿；纵隔窗示细结节影最密集区呈线状或点簇状钙化，其内缘通常似“火焰”状。ＨＲＣＴ：肺野呈“磨玻璃”样，结节大小稍有区别，部分小叶间隔增厚。结论：Ｘ线平片是发现并提示本病最基本的手段，平片上所谓的胸膜及心包的增厚或钙化，实为胸膜下微结石密集重叠加之Ｘ线切线投影所致的视觉效果；ＣＴ尤其ＨＲＣＴ能更准确地反映其病理特点及病程。Objective:To describe the X-ray and CT features of pulmonary alveolar microlithiasis and discuss the signification of features.Materials and Methods:The plain film and CT findings of 4 cases of pulmonary alveolar microlithiasis(male 2 cases,female 2 cases,aged from 21～32)proved by lung biopsy or clinical diagnosis were retrospectively analysed.Results:On plain film,4 cases have very fine sandlike micronodulations diffusely involving both lung,3 cases are most marked in the middle and lower zone,2 cases have obliteration of the pericardium and diaphragmatic contours,2 cases have so-called thinkening or calcification of pleura and pericardium,1 cases has consolidation of lingula lobe.On conventional CT,pulmonary window revealed numerous fine micronodulation in the parenchyma,which exceptionally high concentrated in the subpleural parenchyma,3 cases combined with pulmonary emphysema,mediastinal window showed linear or punctate calcifications in the micronodulation concrete area,which appeared flamelike in the medial border. On HRCT,pulmonary window revealed diffuse ground-glass change,differ size nodule and thinkening of lobular septa.Conclusion:Plain film is a primary method for finding and suggesting PAM.So-called thinkening or calcification of pleura and pericardium in the plain film should be caused by a visual effect produced by heavy concentration of microliths in the subpeural parenchyma.CT especially HRCT,can better demonstrate pathological features and stage of PAM, and play a very important role in diagnosis and differential diagnosis.

关 键 词：肺泡微石症 X线平片 CT 肺疾病 

分 类 号：R563.904[医药卫生—呼吸系统] R816.41[医药卫生—内科学]