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目的 :分析 7例肺泡蛋白沉积症的胸部X线及电子计算机体层扫描 (CT)征象 ,探讨其影像诊断价值。方法 :回顾性分析 7例经病理证实的肺泡蛋白沉积症患者的胸部X线及CT征象。结果 :胸片主要显示肺泡性浸润。胸部CT比胸片更能清楚地显示病变的性质 ,CT既能显示肺泡性浸润又能显示间质异常。肺泡性浸润主要表现为两肺广泛的结节、斑片、大片实变影及毛玻璃影 ,部分斑片影与周围正常肺实质的分界锐利形成地图样改变。间质异常主要表现为线状、网状影及小叶间隔增厚影 ,小叶间隔增厚常出现于毛玻璃影区形成碎石路样改变。结论 :毛玻璃影、地图状分布的斑片影、碎石路样改变有一定的特征性 ,结合临床表现 ,能高度提示诊断。确诊需依靠肺活检及肺部灌洗检查。
OBJECTIVE: To analyze the chest X-ray and computed tomography (CT) signs of 7 cases of pulmonary alveolar proteinosis and discuss the diagnostic value of imaging. Methods: The chest X-ray and CT findings of 7 patients with pathologically confirmed pulmonary alveolar proteinosis were retrospectively analyzed. Results: The chest radiograph mainly showed alveolar infiltration. Chest CT clearly shows the nature of the lesion better than chest radiograph. CT can show both alveolar infiltrates and interstitial abnormalities. Alveolar infiltration is mainly manifested as extensive pulmonary nodules, patches, large consolidation and gross glass shadow, part of the patch of shadow and surrounding normal lung parenchyma sharp changes in the formation of the map-like changes. Interstitial abnormalities mainly manifested as linear, reticular shadow and interlobular thickened shadow, interlobular septa often appear in the ground glass shadow formation of gravel road-like changes. Conclusion: There are some characteristic features such as ground glass shadow, map-like patchy patches and gravel road-like changes. Combined with clinical manifestations, it is highly suggestive of diagnosis. Diagnosis depends on lung biopsy and lung lavage check.