肺韦格纳肉芽肿的CT表现(附二例报告并文献复习)

目的 探讨肺部Wegener肉芽肿病的CT表现,提高对此病的认识.方法 对活体组织检查证实2例及文献中108例肺部韦格纳肉芽肿病患者的CT表现进行回顾性分析.结果 多发病变81例(73.6％),其中多发结节为主64例(79.0％),多发实变及磨玻璃影为主17例(21.0％),2种影像经常同时出现；单发病例29例(264％),其中单发结节或肿块17例(58.6％),单发实变或磨玻璃影10例(34.5％),肺不张2例(6.9％)；伴随征象:空洞69例(62.7％)；毛刺征象37例(33.6％)；供养血管征11例(10.0％):楔形病灶11例(10％)；胸腔积液11例(10％)；支气管壁增厚、扩张8例(7.3％)；淋巴结肿大4例(3.6％)；结论 韦格纳肉芽肿病的临床、影像表现多样；多发结节并空洞、多发实变及磨玻璃影是肺部韦格纳肉芽肿病最为常见的影像学表现,结节边缘出现细长毛刺或针刺样、供养血管征及楔形病灶有助于诊断:密切结合临床、病理及影像特点.综合分析才能减少误诊.

The CT findings of pulmonary Wegener' granuiomatosis: two cases report with literature review

Objective To study the CT features of pulmonary Wegener＇ granulomatosis （WG）and improve the awareness. Methods The CT findings of 2 patients with WG proved by piopsy and 108 patients with pulmonary WG reported in the literature were retrospectively analyzed. Results 81 cases （73.6%） showed pulmonary multiple lesions, including multiple nodules and patchy infiltrations of 64 cases （79%）, multiple pulmonary consolidation and ground-glass sign of 17 eases （21%）, multiple nodules and infihrates were the most common lesions and often coexisted; 29 patients showed a single lesion（26.4%）, including single nodule was seen in 17 eases（58.6%）, single infiltration or ground-glass sign were seen in 10 eases （34.5%）, pulmonary ateleetasis were seen in 2 cases（6.9%）; the accompanied signs included cavitation （69 cases ,62.7%）; Spiculation （ 37 cases, 33.6%）;＂vascular sign＂（11 patients ,10%）; Wedge-shaped lesions （ 11 patients ,10%）; Pleural effusion showed in 11 patients of total （10%）; Bronchial wall thickening and bronchiectasis showed in 8 cases of the total （7.3%）; Lymph node enlargement showed in 4 cases of total （3.6%）. Conclusion Clinic and imaging manifestation of WG are miscellaneous, multiple nodules and cavitations of the lung and multiple patchy infiltrations and ground-glass sign are the most common signs. It is helpful to the diagnosis when speculation in the margin of nodules ,vascular sign and wedge-shaped lesions; It may decrease misdiagnosis if combined with the clinical,pathological and images closely.