胸部结节病的影像诊断与鉴别诊断

目的分析胸部结节病的影像学特征及鉴别诊断方法,提高其影像诊断水平。方法回顾性的分析36例经确诊的胸部结节病的胸部平片及CT影像资料。结果X线胸片及胸部CT提示双侧肺门淋巴结增大27例(75%),无双侧肺门淋巴结肿大者为不典型胸部结节病,9例(25%)呈不典型表现;肺部异常表现在75%的病例都发现了微结节或结节,其他异常包括小叶间隔增厚15例(41.7%),纤维化表现12例(33.3%),磨玻璃影10例(27.8%),血管支气管集聚7例(19.4%),斑片或实变影5例(13.9%)。结论结节病临床表现多样而无特异性,容易引起误诊。CT检查能发现淋巴结肿大,又可显示肺内特征性改变,可提高诊断准确率。

Imaging and differential diagnosis of pulmonary sarcoidosis

Objective To analyze the radiological features and differential diagnosis of pulmonary sarcoidosis.Methods A total of 36 patients with definite pulmonary sarcoidosis were retrospectively analyzed by using X-ray chest films and CT scan.Results X-ray and CT examination results showed 27 cases with enlargement of lymph nodes in bilateral hilus pulmonis and 9 cases with atypical thoracic sarcoidosis.75% of the cases were micronodules or nodules,other abnormality included 15 cases(41.7%) of thickened interlobular septa,and 12 cases(33.3%) of parenchymal fibrosis,10 cases(27.8%) of ground-glass opacity,7 cases(19.4%) of central conglomeration of vessels and bronchioles,5 cases(13.9%) of patchy areas of alveolar consolidation.Conclusion The clinical presentation of sarcoidosis is varied and nonspecific and the diagnosis is easily mistaken.But there are some specific radiographic features of CT scan in finding enlarged lymph nodes,especially in finding pulmonary infiltrations.It is helpful to improve correct diagnostic rate.