胸内结节病的CT诊断分析  

Analysis of CT Diagnosis of Pulmonary Sarcoidosis

作　　者：田岳华[1] 刘雨成[1] 郭嘉漪[1] 何银[1] 

机构地区：[1]连云港市第一人民医院影像科,江苏222002

出　　处：《放射学实践》2009年第8期842-846,共5页Radiologic Practice

摘　　要：目的:探讨和分析胸内结节病的CT表现及特征。方法:回顾性分析24例经病理证实的结节病的临床资料及CT影像学表现。结果:胸内淋巴结肿大22例,其中肺门和纵隔淋巴结均肿大16例,仅肺门淋巴结肿大3例,仅纵隔淋巴结肿大2例,内乳淋巴结肿大1例;淋巴结钙化2例。17例行增强扫描,其中12例呈中等以上均匀强化,2例囊变,2例呈环行强化,1例无强化。24例中既有胸内淋巴结肿大同时发现肺部浸润改变19例,结节15例,其中小结节12例,大结节3例;结节大小、多种分布形式同时存在的2例;团块5例;毛玻璃影3例;支气管血管束增粗10例;小叶间隔线影11例;支气管狭窄4例;胸膜结节、增厚及胸腔积液各1例。结论:胸内结节病是结节病的局部表现,缺乏特异性,影像学形态多样,CT检查对肺门纵隔淋巴结肿大尤其对肺实质病变的表现具有一定特征性,有助于提高诊断准确率,对临床观察疗效具有指导作用。Objective：To investigate and analyze CT features of pulmonary sarcoidosis. Methods：Twenty-four patients with sarcoidosis proved pathologically were retrospectively analyzed by using CT scan and clinical recordings. Results： The main CT findings of pulmonary sarcoidosis were enlarged intrathoracic lymph nodes （n= 22）. The lymph nodes were found in pulmonary hilum （n= 3）, in mediastinum （n= 2）, in both pulmonary hilum and mediatinum （ n = 16 ）. Enlarged internal mammary nodes were seen in one case. Calcified lymph nodes were seen in two cases. Enhanced CT scanning was performed in seventeen cases. The lymph nodes appeared moderate enhancement （n= 12）, cystic change （n： 20）, circular enhancement （n： 2） and no enhancement （n= 1）. In all the twenty-four cases, intrathoracie enlarged lymph nodes and pulmonary infiltra- tions co-existed in nineteen cases. The CT findings of pulmonary infiltration included nodules （n= 15）： small nodules （n= 12）, big nodules （n：3） and mixed nodules （n=2） ;mass （n=5） ;ground-glass appearance （n= 3） ; thickening of broncho- vascular markings （ n = 10） ; interlobular septal lines （ n = 11 ） ; bronchial stenosis （ n = 4 ） ; pleural nodular thickening （ n= 1 ） and pleural effusion （n= 1 ）. Conclusion： Pulmonary sarcoidosis is the local appearance of sarcoidosis, lacking specificity. The radiolographic findings are varied. But there are some specific radiographic features of CT scan in finding enlarged hilar and mediatinal lymph nodes,especially in finding pulmonary infiltrations. CT scan is helpful to improve correct diagnostic rate and to direct clinical observance of theraputic effect.

关 键 词：胸部 结节病 肺 体层摄影术 X线计算机 

分 类 号：R816.4[医药卫生—放射医学]