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目的 研究支气管血管束胸部高分辨率CT(HRCT)的正常、异常表现及其病理学基础 ,并评价其对弥漫性肺疾病的诊断价值。方法 对 6例新鲜尸检肺脏标本及 8例全肺或肺叶切除标本进行HRCT与病理对照研究。采用Heitzman法充气膨胀固定标本并行HRCT扫描 ,然后将标本切成10mm厚片摄取软X线片 ,进行影像、病理对照。对 10 0例经病理或临床证实诊断为弥漫性肺疾病者行HRCT检查 ,并进行分析。结果 支气管血管束增粗及边缘毛糙不规则、扭曲变形者 ,其病理改变包括支气管血管周围间质及其肺实质炎症及纤维化 ;小叶中央支气管血管束异常、表现为小叶核影增大者 ,在煤工尘肺为小叶内支气管血管周围尘肺结节所致 ,在癌性淋巴管炎为小叶内以血管为中心的癌细胞结节所致 ;小叶核分支状影增多者 ,病理表现为小叶内细支气管扩张并见管壁及周围肺组织炎症细胞浸润。在 80例以肺间质为主的病变中 ,支气管血管束增粗、边缘毛糙、扭曲变形主要见于慢性支气管炎合并间质纤维化及胶原病肺纤维化 ;支气管血管束增粗呈结节状征象者 ,在 2 0例结节病病例中见 8例 ,8例癌性淋巴管炎病例中见 6例 ,5例淋巴瘤病例中见 3例 ,15例煤工尘肺病例中见 2例。在 2 0例以支气管为主的病变中 ,小叶核分支状影增多者有 14例 (70 % )。结论 根据?
Objective To study the normal, abnormal expression and pathological basis of high resolution CT (HRCT) of bronchovascular bundles and to evaluate its diagnostic value for diffuse pulmonary diseases. Methods Six cases of fresh autopsy lung specimens and eight cases of whole lung or lobectomy specimens were studied by HRCT and pathology. Heitzman method of inflated and fixed specimens parallel HRCT scan, and then the specimen cut into 10mm thick piece of soft X-ray film for imaging and pathological control. HRCT examination was performed on 100 cases diagnosed as diffuse pulmonary diseases by pathology or clinic and analyzed. Results The bronchovascular bundles were rough and the edges were rough and distorted. The pathological changes included bronchovascular perivascular interstitial and pulmonary parenchymal inflammation and fibrosis. The central bronchovascular bundle was abnormal, In coal workers pneumoconiosis lobular bronchial pneumoconiosis around the pneumoconiosis nodules caused by lymphangitis in the cancerous lobules vascular-centric cancer cell nodules caused by; lobular nuclear branch shadow increased, the pathological manifestations of lobular Bronchioles dilate and see infiltration of inflammatory cells in the wall and surrounding lung tissue. In the 80 cases of pulmonary interstitial-based lesions, the bronchovascular bundle thickening, rough edges, distortion mainly seen in chronic bronchitis with interstitial fibrosis and collagenosis pulmonary fibrosis; bronchial vascular bundle thickening nodular Signs, in 20 cases of sarcoidosis seen in 8 cases, 8 cases of cancerous lymphangitis in 6 cases, 5 cases of lymphoma in 3 cases, 15 cases of coal workers with pneumoconiosis cases in 2 cases. Among 20 patients with bronchial lesions, there were 14 cases (70%) with increased lobular nuclear branches. Conclusion based?