胸部结节病的CT诊断  

Image Features of Thoracic Sarcoidosis on CT

作　　者：秦卫和 刘亮 文兵 陈学文 Qin Weihe;Liu Liang;Wen Bin;Chen Xuewen(Department of Radiology,Yiyang Central Hospital affiliated to Hunan University of Traditional Chinese Medicinel,Yiyang,Hunan 413000)

机构地区：[1]湖南中医药大学附属益阳中心医院放射科,湖南益阳413000

出　　处：《现代医用影像学》2024年第3期411-415,共5页Modern Medical Imageology

基　　金：湖南省科技厅临床医疗技术创新引导项创目,项目编号:2020SK52503。

摘　　要：目的:通过回顾性分析确诊胸部结节病的CT资料,寻找胸部结节病特征性的CT征象,加深对该病的认识。方法:25例确诊的胸部结节病患者,男性11例,女性14例,年龄20-76岁,平均56.7岁.25例均做了CT平扫,10例同时做了CT增强扫描。结果:25例中21例有淋巴结肿大,双侧肺门对称性淋巴结肿大加纵隔多发肿大淋巴结18例,2例有纵隔淋巴结增大,无双侧肺门淋巴结增大,1例纵隔淋巴结增大伴右侧肺门淋巴结增大。10例增强扫描见增大淋巴结有中度均匀强化,平扫时CT值44.5Hu,动脉期CT值67.1Hu,静脉期CT值75.3Hu,增大淋巴结的边界较清楚,相互之间无融合。3例可见肺门及纵隔淋巴结呈蛋壳样钙化。21例中15例患者有肺部改变,13例表现为肺内多发小结节影,结节多在5mm以下,小结节分布在淋巴管周围,以支气管血管束周围、胸膜下及小叶间隔内分布居多。2例可见反晕征。2例肺内可见磨玻璃影及小片状实变影。2例双上肺可见肺纤维化病灶。3例肺内可见气体潴留,呈马赛克征象。1例可见右侧主支气管壁增厚,管壁上可见细小结节影。2例有双侧胸膜增厚,4例有双侧胸腔少量积液。2例可见心包少量积液。结论:胸部结节病的典型CT表现为双侧肺门对称性淋巴结增大及纵隔淋巴结增大,肺内沿淋巴管周围分布的多发性小结节亦有助于胸部结节病的诊断。Objective:The CT data of confirmed thoracic sarcoidosis were retrospectively analyzed to look for characteristic CT signs and to deepen the understanding of the disease.Methods:25 patients with confirmed chest sarcoidosiswere analyzed retrospective,11 males and 14 females,aged 20-76 years,with a mean of 56.7 years.All 25 cases had CT plain sweeps and 10 cases had simultaneous CT-enhanced scans.Results:18 cases showed bilateral hilar lymph node enlargement and mediastinal lymph enlargement..Mediastinal lymph node enlargement and no bilateral hilar lymph node enlargement were found in 2 cases.1 case of mediastinal node enlargement with right hilar lymph node enlargeme.There were 15 cases with pulmonary changes,Thirteen patients showed multiple small nodules in the lung,and the nodules were mostly below 5mm,The distribution of nodules is mainly around the lymphatic vessels,mainly around the bronchial vascular bundle、in the subpleural area,and within the interlobular septum.Ground glass or consolidation were observed in the lungs in 2 cases.There were 2 cases with reversed halo sign,and pulmonary fibrosis were found in 2 cases.Gas retention were observed in the lungs in 3 cases.Right main bronchial wall thickening and small nodular shadow on the tube wall were found in lcase.Pleural thickening were found in 2 case,pleural effusion in 4 cases,and small effusion of the pericardium in 2 cases.Conclusion:Most thoracic sarcoidosis had the typical CT findings of bilateral hilar lymph node enlargement and mediastinal lymph enlargement,Multiple small nodules distributed in the lung along the surrounding lymphatic vessels may also facilitate the diagnosis of thoracic sarcoidosis.

关 键 词：结节病 胸部 X线计算机 

分 类 号：R816.4[医药卫生—放射医学] R561[医药卫生—临床医学]