呼吸性细支气管炎伴纤维化的HRCT表现  

HRCT findings of respiratory bronchiolitis with fibrosis

作　　者：梁毅[1] 谢标林 LIANG Yi;XIE Biaolin(Department of Radiology, Jiangbin Hospital of Guangxi Autonomous Region, Nanning 530021, China)

机构地区：[1]广西壮族自治区江滨医院放射科

出　　处：《国际医学放射学杂志》2019年第5期521-525,共5页International Journal of Medical Radiology

摘　　要：目的探讨HRCT影像特征对呼吸性细支气管炎伴纤维化(RBF)的诊断价值。方法回顾性分析16例RBF病人[男14例,女2例;平均年龄(65±7)岁]与16例呼吸性细支气管炎相关性间质性肺疾病(RB-ILD)病人[男15例,女1例,平均年龄(62±8)岁]资料。采用t检验、χ^2检验和Fisher确切概率法比较2组病人的临床资料、肺气肿HRCT类型和肺间质改变HRCT表现的分布特点。结果 RBF组病人肺气肿HRCT类型以间隔旁型和混合型为主,RB-ILD组以小叶中央型和无肺气肿为主,2组病人肺气肿HRCT类型分布差异有统计学意义(P<0.05)。RBF组有网状影者多于RB-ILD组,RB-ILD组有小叶中心性结节者多于RBF组(均P<0.05)。2组间磨玻璃样影、支气管壁增厚、空气潴留差异均无统计学意义(均P>0.05)。RBF组病人网状影主要分布于上叶或混合分布,而RB-ILD组病人网状影主要分布于下叶。2组病人磨玻璃样影以弥漫分布或下叶居多,小叶中心性结节分布则以上叶或混合分布居多。结论 RBF的HRCT特征性表现为以上肺分布为主的肺气肿,伴邻近胸膜下肺间质轻度网状改变。结合HRCT表现与吸烟史可对RBF病人进行初步影像诊断。Objective To investigate the diagnostic value of HRCT in identifying respiratory bronchiolitis with fibrosis(RBF). Methods Sixteen patients with RBF(male/female 14/2;age 65±7 years) and 16 patients with respiratory bronchiolitis-interstitial lung disease(RB-ILD)(male/female 15/1;age 62 ±8 years) were retrospectively collected. The common clinical data, characteristic distribution of emphysema and pulmonary interstitial lesions on HRCT findings were compared between the RBF and RB-ILD groups with t test, Chi-square test or Fisher’s exact test when were appropriate.Results HRCT types of emphysema with RBF group were predominantly centrilobular emphysema and mixed emphysema,while the RB-ILD group presented predominantly centrilobular emphysema and no emphysema. The distributions of emphysema on HRCT were significantly different between the 2 groups(P<0.05). Presence of reticulation were more common in the RBF group than in the RB-ILD group. However, presence of centrilobular nodules were more common in the RB-ILD group than in the RBF group(P<0.05). The differences in ground-glass opacity, bronchial thickening, and air trapping were not statistically significant between the 2 groups(all P>0.05). The reticulation was predominantly distributed in the upper or multiple lobes in the RBF group, but the reticulation was predominantly distributed in lower lobes in the RB-ILD group. Most of the ground-glass opacity lesions in the 2 groups were distributed in diffuse or lower lobes, and most of the centrilobular nodules in the 2 groups were distributed in the upper or multiple lobes. Conclusion RBF has characteristic imaging appearances on HRCT, and the characteristic HRCT finding is emphysematous at upper lung zones with mild reticulation at subpleural areas. Considering smoking history, the HRCT can provide basis for clinical diagnosis of RBF.

关 键 词：支气管炎 纤维化 高分辨力CT 间质性肺疾病 

分 类 号：R562[医药卫生—呼吸系统] R563[医药卫生—内科学]