肺部结节病CT特征及误诊分析  

Analysis of Misdiagnosis and CT Features of Pulmonary Sarcoidosis

作　　者：鄂林宁[1] 吴吉利[2] 杨州[1] 李健丁[1] 

机构地区：[1]山西医科大学第一医院放射科,030001 [2]太原市第四人民医院放射科,030053

出　　处：《临床放射学杂志》2011年第11期1614-1617,共4页Journal of Clinical Radiology

基　　金：山西省科技攻关项目(编号:20090311058-1)

摘　　要：目的分析肺部结节病多排螺旋CT的特征性影像学表现。资料与方法回顾性分析经病理证实的42例肺部结节病患者的多排螺旋CT影像资料,总结其特征性CT表现。结果 42例结节病首诊误诊11例(26.19%)。影像学表现:肺门纵隔淋巴结增大28例,仅肺门淋巴结增大12例,仅纵隔淋巴结增大1例,肺门纵隔均无淋巴结增大1例;肺内结节沿支气管血管束及胸膜下分布为主38例;肺内不规则大片状实变区1例;小叶间隔不规则结节样增厚8例;支气管牵拉性扩张3例;肺内纤维索条影13例;胸膜下蜂窝影6例;双肺磨玻璃密度影16例;肺内结节病合并双侧乳腺受累1例;上颌窦受累1例;鼻部皮下结节1例。结论肺部结节病的CT表现有一定特征性,最重要的影像学征象是肺内沿淋巴道分布的小结节以及肺门纵隔淋巴结增大,部分不典型结节病影像学诊断困难,应积极进行穿刺活检。Objective To analyze multidetector computed tomography（MDCT） features of pulmonary sarcoidosis.Materials and Methods MDCT features of 42 patients with sarcoidosis proved pathologically were retrospectively analyzed.Results 11 patients（26.19%） were misdiagnosed among 42 patients with sarcoidosis.The main CT features of pulmonary sarcoidosis included：the enlarged lymph nodes were found in pulmonary hilum（n=12）,in mediastinum（n=1）,in both pulmonary hilum and mediatinum（n=28）,there was no abnormal findings of intrathoracic lymphnodes in one patient.The nodules of pulmonary mostly distributed around the bronchovascular bundle（n=38）.Other abnormalities included consolidation（n=1）,interlobular septal lines（n=8）,bronchial distortion（n=3）,linear shadow（n=13）,honeycombing shadow（n=6）,ground glass opacity（n=16）.Conclusion There are some specific CT features of pulmonary sarcoidosis,such as enlarged hilar and mediatinal lymphnodes,multiple tiny nodules distributed along lymphatic pathways,some patients with thoracic sarcoidosis have atypical CT appearances,biopsy is necessary.

关 键 词：结节病 肺 体层摄影术 X线计算机 

分 类 号：R816.41[医药卫生—放射医学] R563.9[医药卫生—临床医学]