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目的:探讨和分析使用CT诊断慢性肺部间质性病变的临床效果,总结临床经验。方法:回顾性分析2009年10月至2011年10月在我院就诊的20例慢性肺部间质性病变患者的完整临床资料,总结其通过CT检查进行诊断的准确性。结果:本组20例患者在进行CT检查时,有2例患者无异常情况,有18例(占80.0%)患者的肺部有阳性表现,其中有16例患者有肺部纹理增多、增粗、紊乱、模糊等表现,有2例患者的肺部有斑片状模糊高密度影的表现,有2例患者的肺部有网格状模糊影的表现。本组患者肺部的主要影像学特征为:(1)肺小叶间隔不规则增厚,主要表现为胸膜下肺小叶内有细线状或细网状影。(2)肺部网状改变,主要表现为肺内胸膜下及两肺下叶基底段多发网织状阴影。(3)肺部有磨玻璃样密度影,主要表现为多发斑片状影,边缘不清,密度较淡,其间可见肺纹理。随着病情的进展,这些病灶可融合成肺段实变影。(4)小叶性肺气肿,主要表现为多发无壁小圆形透亮影。(5)蜂窝肺,主要表现为肺内聚集大量小囊腔,似蜂窝状,以肺下叶多见。(6)支气管呈囊状、柱状扩张。(7)胸膜增厚。结论:高分辨CT检查具有用法简便、易操作、分辨率高的优点,在诊断肺部间质性病变方面具有较高的临床价值,值得在临床上推广使用。
Objective: To explore and analyze the clinical effect of CT diagnosis of chronic pulmonary interstitial lesions and summarize the clinical experience. Methods: The complete clinical data of 20 patients with chronic interstitial lung disease who were seen in our hospital from October 2009 to October 2011 were retrospectively analyzed. The diagnostic accuracy of the CT examination was summarized. Results: Twenty patients in this group had no abnormality during the CT examination. There were 18 cases (80.0%) of the patients had positive pulmonary manifestations. Among them, 16 patients had lung texture increase and thickening , Disorder, blur and so on. There were 2 patients with patchy blurred high-density images of the lungs, and 2 patients had a grid-like blurred shadow in the lungs. The main imaging features of the lungs of this group of patients are: (1) irregular lobulation of the interlobular septa, the main manifestations of subpleural lung lobules with fine lines or fine reticular shadow. (2) Pulmonary reticular changes, mainly in the lung subpleural and basal lobes of both lungs multiple hairy reticular shadows. (3) There are ground glass-like density of the lungs, mainly for the multiple patchy shadow, unclear edge, the density of light, during which lungs can be seen. As the disease progresses, these lesions can be fused into segments of consolidation. (4) lobular emphysema, mainly for multiple non-small round translucent shadow. (5) honeycomb lung, mainly for the accumulation of a large number of small cysts in the lungs, like honeycomb, more common in lower lobe of the lungs. (6) Bronchial cystic, cylindrical dilatation. (7) pleural thickening. Conclusion: High-resolution CT has the advantages of simple and convenient operation, high resolution and high clinical value in the diagnosis of pulmonary interstitial lesions, which is worth popularizing in clinic.