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目的:通过回顾性分析肺泡蛋白沉积症(Pulmonary alveolar proteinosis,PAP)的64层螺旋CT表现,探讨64层螺旋CT快速容扫描(VCT)在肺泡蛋白沉积症诊断中的应用价值,旨在提高对本病的CT诊断水平。方法:本组所有病例均行64层CT快速容积扫描,其中4例行CT导引下经皮肺穿刺活检,8例行肺泡灌洗,4例经纤维支气管镜活检,均得到病理证实。结果:HRCT表现:两肺散在或弥漫性斑片状磨玻璃影、边界清楚(“地图样”改变),小叶间隔增厚交织(“铺路石样”改变)及实变区“空气支气管征”。结论:肺泡蛋白沉积症的HRCT表现具有相对特征性,充分了解肺泡蛋白沉积症的VCT表现,并做相关疾病的鉴别诊断,能很大程度提高对本病诊断的准确率,最终诊断依靠肺部穿刺或肺泡灌洗后确诊。
OBJECTIVE: To evaluate the value of 64-slice spiral CT in the diagnosis of pulmonary alveolar proteinosis by retrospectively analyzing the 64-slice spiral CT findings of Pulmonary Alveolar Proteinosis (PAP) CT diagnosis of the disease. Methods: 64 cases of CT volume scan were performed in all the cases. Four cases underwent CT guided percutaneous lung biopsy, eight cases of bronchoalveolar lavage and four cases of bronchoscopic biopsy were confirmed by pathology. RESULTS: The HRCT findings were scattered or diffuse patchy ground glass in both lungs with clear boundaries (“map” pattern), thickening of the interlobular septum (“paving stone” pattern), and consolidation zone “Air bronchogram”. Conclusions: The HRCT findings of pulmonary alveolar proteinosis are relatively characteristic. To fully understand the VCT manifestations of pulmonary alveolar proteinosis and to make the differential diagnosis of related diseases, the diagnostic accuracy of this disease can be greatly improved. The final diagnosis depends on the lung Puncture or alveolar lavage confirmed.