肺间质性疾病的HRCT表现及相关病理研究

目的：分析肺间质性疾病的HRCT表现及其与病理学的关系。方法：38例经手术病理证实的肺间质纤维化患者和疾病对照组14例分别行HRCT扫描、组织病理学检查（包括HE、Masson氏三色染色）及免疫组化。结果：早期组中肺小叶间隔增厚81.25%，肺内渗出毛玻璃影18.75%，肺内小结节影66.67%，胸膜下曲线12.5%；中、晚期组中肺小叶间隔纡曲、僵直、变形85.71%，支气管血管束纡曲、僵直35.71%，范围较广的肺气肿32.14%，蜂窝肺28.57%，胸膜增厚39.29％。结论：HRCT是一种安全、反映准确、无创性的诊断ILD的手段，经与病理对照、毛玻璃影、小叶间隔增厚，肺内小结节影、网状影和胸膜下曲线是ILD早期征象；而肺小叶间隔纡曲、僵直、变形，支气管血管束纡曲、僵直，范围较广的肺气肿及蜂窝肺是中、晚期的征象。

HRCT appearances and associated pathological study of interstitial lung diseases

Objective:To analyze the HRCT appearances of interstitial lung diseases (ILD).Methods:38 cases with pathologically proved ILD and 14 cases of control group were performed HRCT scanning,histological and immunohistochemistry examinations.Histological examinations included HE staining and Masson's trichrome staining.Results:Early stage interstitial lung diseases had the following HRCT findings:interlobular septal thickening (81.25%),ground glass opacity(18.75%),tiny nodular shadow(66.67%),and subpleural curved lines(12.5%).On the other hand,median and late stage had the following HRCT findings:twisting,rigidity and irregularity of interlobular septa (85.71%) and bronchovascular bundles(35.71%),emphysema (32.14%),honeycombing (28.57%) and pleural thickening (39.29%).Conclusion:HRCT is a safe,sensitive and non invasive method in the diagnosis of ILD.The HRCT features are well correlated with the pathological findings.