肺泡蛋白沉积症的HRCT诊断  

High resolution CT features of pulmonary alveolar proteinosis

作　　者：李佩玲[1] 刘屹[1] 赵宇[1] 黎庶[1] 

机构地区：[1]中国医科大学附属第一医院放射科,辽宁沈阳110001

出　　处：《解剖科学进展》2016年第1期39-41,共3页Progress of Anatomical Sciences

摘　　要：目的分析肺泡蛋白沉积症(pulmonary alveolar proteinosis,PAP)的高分辨CT(High resolution CT,HRCT)表现特点,提高对本病的诊断能力。方法回顾性收集我院收治并经肺泡灌洗或肺活检证实的PAP患者12例。所有病例均接受1次或多次HRCT检查,分析其HRCT表现特点。结果肺泡灌洗液及病理切片均证实12例肺泡腔内为PAS染色阳性嗜酸性沉积物,HRCT均表现为双肺多发的磨玻璃样密度影,边缘模糊,与周围组织分界清楚,呈"地图样"表现(100%),8例内部可透见细网状影(占66.7%);6例病变局部呈实变的片状影(50%)。12例中病变未累及的区域HRCT均表现正常(100%);所有病例均未见纵隔、肺门淋巴结肿大(100%)。6例随访病例其CT影像表现与临床症状呈同步变化。结论 PAP的HRCT表现具有一定的特征性,有利于该病的正确诊断及病情随访观察。Objective To analyze the high resolution CT（HRCT） image features of pulmonary alveolar proteinosis（PAP） to provide a basis for the diagnosis of PAP.Methods A total of 12 patients suffering from PAP proved by lung biopsy and bronchoalveolar lavage were retrospectively collected and underwent HRCT scanning once or several times,HRCT appearances and features were analyzed.Results HRCT images of all 12 cases presented multiple ground-glass opacities with obscure-defined margins,showing ＂geographic＂ pattern（100%）,slim renticular shadow（8 cases,66.7%）,local pulmonary parenchyma presenting patchy shadows（6 cases,50%）,with no enlarged hilar and mediastinal lymph nodes visualized for all cases（100%）.For 6 recurrent cases,the followed-up CT findings and clinical manifestations changed almost synchronously.Both bronchoalveolar lavage fluid and pulmonary pathological section confirmed alveolar accumulation of eosinophilic material with PAS staining positively.Conclusion The characteristic HRCT appearances of PAP is beneficial for the accurate diagnosis of PAP and clinical observation of its development.

关 键 词：肺泡蛋白沉积症 体层摄影术 X线机 高分辨 

分 类 号：R445.4[医药卫生—影像医学与核医学]