隐源性机化性肺炎的MDCT诊断和随访  

Diagnosis and follow-up of cryptogenic organizing pneumonia with multi-detector CT

作　　者：马延贺[1] 李东[1] 于静[1] 于铁链[1] 叶宁[1] 王卿[1] 

机构地区：[1]天津医科大学总医院放射科,天津300052

出　　处：《实用放射学杂志》2013年第2期202-204,227,共4页Journal of Practical Radiology

基　　金：天津市应用基础及前沿技术研究计划项目（10JCYBJC11000）.

摘　　要：目的探讨隐源性机化性肺炎（COP）的MDCT表现及其治疗后的影像学变化。方法收集经病理证实的COP患者15例，治疗前后均行胸部MDCT扫描，部分在随诊中多次行胸部MDCT扫描。将COP的表现分为实变影、磨玻璃密度影、结节影和不规则线样影，分析各种病灶的分布特征。对比COP治疗前后的胸部MDCT，观察其前后变化特点。结果15例COP患者中，12例可见实变，以胸膜下或血管支气管周围分布为主；13例可见磨玻璃密度影，随机分布为主；4例可见结节样影；3例呈线样或网状影。MDCT显示激素治疗对15例患者均有效。结论MDCT对COP的诊断具有重要价值，诊断最终依赖临床一放射一病理相结合，MDCT可用作治疗效果评价方法。Objective To study MDCT findings of cryptogenic organizing pneumonia （COP} and the imaging changes after treat- ment. Methods 15 cases with COP confirmed by biopsy and pathological examination during 2006 to 2012 were collected. MDCT was performed before and after treatmeat, and in follow-up period in all cases. The distribution of the lesions which showed as con- solidation, ground-glass opacity, nodules and irregular line shadows were analysed, and the changes of these lesions were compared between pre-and post -treatment. Results The main clinical manifestations were dry cough （11/15） and fever （10/15）. MDCT scans demonstrated patchy consolidations in 12 patients, the lesions distributed predominantly at subpleural and/or peribronchovascular ar- eas. 13 patients demonstrated as random distribution of ground-glass opacity. Nodules and irregular lines were other common CT findings. Enlarged lymph nodes （1--1.5 cm） were detected in the mediastinum. Glucocorticoid treatment was significantly effective in 15 patients. Conclusion MDCT scans are valuable in diagnosis, follow-up of COP. The final diagnosis of COP requires combina- tion of clinical, MDCT and pathological manifestations.

关 键 词：肺 隐源性机化性肺炎 计算机体层成像 

分 类 号：R563.1[医药卫生—呼吸系统]