特发性间质性肺炎38例的影像学特征

目的探讨特发性间质性肺炎的影像学特征。方法报道38例临床诊断为特发性间质性肺炎（IIP）病例,并结合相关文献分析。结果主要症状和体征为进行性呼吸困难、胸闷、咳嗽、咳痰、肺底部闻及Velcro啰音。CT或高分辨率CT（HRCT）显示：两肺弥漫性磨玻璃状、网状、蜂窝状改变,病变分布以两肺外带、胸膜下为主,病灶自肺尖向肺底逐渐加重,两肺基底部病变明显。肺功能有限制性通气功能和弥散障碍,血气分析提示低氧血症I型呼吸衰竭,以激素和氧疗为主的综合治疗有一定效果。结论 IIP的诊断依赖于临床表现、胸部CT/HRCT、肺功能等特征性表现,并除外其他间质性疾病,确诊还需肺活检。

Clinical characteristics and imaging features of idiopathic interstitial pneumonia of 38 cases with idiopathic interstitial pneumonia

Objective To explore the imaging features of IIP.Methods 38 cases which were clinically diagnosed as IIP were retrospectively analyzed combined with correlative literatures review.Results The main symptom were progressive dyspnea,chest tightness,cough,expectoration,Velcro-type crackles heard on the base of bilateral lungs,computed tomography or high resolution computed tomography indicated frosted,reticulate,honeycomb.The lesion mainly distributes in lateral and under pleural of two lungs.The infection aggravates gradually from lung's point to lung's bottom.Pulmonary function test was consistent with restrictive impaiment and impaired gas exchange.The resting arterial blood gases revealed hypoxemia and respiratory failure.Use of steroids and oxygen was partially effective.Conclusion The diagnosis of IIP includes the following clinical symptom,chest CT or HRCT scans,pulmonary function and exclusion of other known causes of interstitial lung disease.The diagnose is based on biopsy examination in lung organization.