摘要
目的回顾性分析肺泡蛋白沉着症(pulmonary alveolar proteinosis,PAP)患者的胸部CT和临床资料,探讨胸部CT表现的动态变化及其临床意义。方法收集本院2007年6月至2012年5月收治的PAP患者15例,男性6例,女性9例,年龄17～53岁,平均37.8岁。12例经临床资料和支气管肺泡灌洗证实,3例经支气管镜或经皮肺穿刺活检病理证实。15例患者共接受26次胸部CT检查,其中1、2、3次胸部CT检查分别为7、5、3例;病例均行肺功能检查。10例共行34次支气管肺泡灌洗(bronchoalveolar lavage,BAL),每例BAL治疗1～6次,7例BAL后复查胸部CT。结果所有病例双肺可见广泛分布的实变影或磨玻璃影,13例次胸部CT见"碎石路"征,即肺部磨玻璃影背景下伴有网状影,12例次小叶间隔增厚,9例次肺纤维化。多数病例肺部病变分布不均,呈"地图样",部分病例肺部病变呈均匀弥漫分布。BAL治疗后复查CT,肺部病变明显好转,病变范围缩小,密度减低。结论肺泡蛋白沉着症患者CT典型表现为双肺广泛分布的实变影、磨玻璃影和"碎石路"征,BAL治疗前后动态CT检查有助于明确诊断和疗效评价。
Objective To investigate the dynamic chest CT characteristics of pulmonary alveolar proteinosis （PAP） and its clinical significance. Methods The CT findings and clinical data were reviewed in 15 patients with PAP, including 6 males and 9 females with the age of 17 -53 years （37.8 years on average）. Twelve patients were confirmed by clinical data and bronchoalveolar lavage, and 3 patients were confirmed pathologically by bronchoscopy or percutaneous lung biopsy. Chest CT scanning was performed for 26 times in the 15 patients, including 7 patients receiving chest CT scanning once, 5 patients receiving chest CT scanning twice and 3 patients receiving chest CT scanning for 3 times, respectively. All the patients were examined for pulmonary function. Bronchoalveolar lavage （BAL） was performed for 34 times in 10 patients, with 1 -6 times for each patient. Seven patients underwent follow-up chest CT scanning after BAL. Results Diffuse pulmonary consolidation or ground glass opacity was observed in all the patients, with ＂crazy paving＂ sign in 13 times of chest CT scanning, thickened interlobular septa in 12 times of chest CT scanning, and pulmonary fibrosis in 9 times of chest CT scanning. ＂geographic pattern＂. In the The lung lesions distributed follow-up chest CT after BAL, extent diminished and the density decreased. Conclusion heterogeneously in most cases and appeared as lung lesions relieved obviously, and the disease The typical CT characteristics of PAP are diffuse pulmonary consolidation, ground glass opacity and ＂crazy paving＂ sign. Dynamic CT scanning before and after BAL is helpful for the diagnosis and theraoeutic evaluation of PAP.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2012年第24期2503-2506,共4页
Journal of Third Military Medical University
基金
第三军医大学临床科研基金(2009XLC19)~~
