HRCT诊断特发性肺纤维化的临床价值观察  

Clinical Value of HRCT in the Diagnosis of Idiopathic Pulmonary Fibrosis

作　　者：万莉莉 胡小萍[1] 徐芳[1] 王蓓蓓 WAN Li-li;HU Xiao-ping;XU Fang;WANG bei-bei(Department of Respiratory and Critical Care Medicine,Wuhan First Hospital,Wuhan 430030,Hubei Province,China)

机构地区：[1]武汉市第一医院呼吸与危重症医学科,湖北武汉430030

出　　处：《中国CT和MRI杂志》2021年第11期70-72,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨高分辨率X线计算机断层摄影(HRCT)诊断特发性肺纤维化(IPF)的临床价值。方法选取2015年1月至2019年6月间收治的42例拟诊为IPF的患者作为研究对象,所有患者均行胸部常规CT及病变局部HRCT。比较各影像学检查诊断IPF效能,并绘制ROC曲线,评估IPF患者各影像学检查表现。结果HRCT诊断IPF灵敏度、特异度、准确率、阳性阴性预测值均高于常规CT、X线;CT及HRCT均可在IPF患者肺部显示弥漫性分布病灶,其中HRCT小叶内间质、间隔不规则增厚显示率、小叶性肺气肿及胸膜下弧线影显示率均高于常规CT(P<0.05),两检查方法支气管扩张、胸膜增厚、网状改变、蜂窝肺及磨玻璃样密度影显示率对比差异均无统计学意义(P>0.05)。本研究中经HRCT确诊的20例IPF患者中,主要病变分布于上肺者5例(25.00%)、分布于下肺者15例(75.00%);分布于中央及肺门者2例(10.00%)、外周分布18例(90.00%);双侧分布20例(100%)。结论HRCT诊断IPF效能良好,有利于IPF鉴别诊断。Objective To investigate the clinical value of high-resolution computed tomography(HRCT)in the diagnosis of idiopathic pulmonary fibrosis(IPF).Methods 42 patients with IPF admitted between January 2015 and June 2019 were selected for the study.All patients underwent chest routine CT and lesion local HRCT.The efficacy of imaging examination on IPF was compared,and the ROC curve was drawn to evaluate the imaging findings of IPF patients.Results The sensitivity,specificity,accuracy rate,and positive and negative predictive values of HRCT in the diagnosis of IPF were higher than those of routine CT and X-ray.CT and HRCT could show the diffuse distribution of lesions in the lungs of patients with IPF,the display rates of the intralobular interstitium,irregular septal thickening,and pan lobular emphysema,and subpleural curvature of HRCT were higher than those of routine CT(P<0.05).There were no significant differences in the display rates of bronchiectasis,pleural thickening,reticular changes,honeycomb lung,and ground glass density shadow between the two examinations(P>0.05).Among the 20 IPF patients diagnosed by HRCT in this study,5 cases(25.00%)of lesions were mainly distributed in the upper lung,and 15 cases(75.00%)were distributed in the lower lung.2 cases(10.00%)were distributed in the central and hilar,and 18 cases(90.00%)were distributed in the periphery.20 cases(100%)were distributed in the bilateral sides.Conclusion HRCT has good efficacy in diagnosing IPF and is beneficial to the differential diagnosis of IPF.

关 键 词：特发性肺纤维化 高分辨率X线计算机断层摄影 诊断 影像学表现 

分 类 号：R445.3[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]