结节病肺内、外影像学特征及肺外累及预测因素的初探

目的 总结结节病肺内、外影像学特征,结合患者临床资料探究结节病肺外累及的预测因素.方法 回顾性分析2012～2020年四川大学华西医院病理学明确诊断为结节病的103例住院患者临床、实验室及影像数据,观察及分析结节病肺内结节分布、纵隔淋巴结增大及肺外器官累及的影像表现,运用最小绝对收缩选择算子法(LASSO法)寻找其肺外...

Preliminary study on the intrapulmonary and extrapulmonary imaging features of sarcoidosis and its ex-trapulmonary involvement predictive factors

Objective To summarize the intrapulmonary and extrapulmonary imaging characteristics of sarcoidosis,and to explore the predictive factors of extrapulmonary involvement of sarcoidosis based on the clinical data.Methods The clinical,laboratory,and imaging data of 103 hospitalized patients with sarcoidosis in West China Hospital of Sichuan University from 2012 to 2020 were retrospectively analyzed.The imaging findings of nodule distribution,mediastinal lymph node enlargement,and extrapulmonary involvement were analyzed.Predictive factors of extrapulmonary involvement were identified by using least absolute shrinkage and selection operator(Lasso)algorithm.Results Among 103 cases of sarcoidosis,95 cases(92.3%)had intrapulmonary lesions and 61 cases(59.2%)had extrapulmonary involvement.There were 92 cases(89.3%)manifested as intrapulmonary nodules,and the nodules were mostly located in the upper lobes of both lungs(84.4%of the right upper lobe,74.8%of the left upper lobe),most nodules were along the subpleural and around bronchial vascular bundles surrounding distribution(82.5%and 65%,respectively).There were 99 cases(96.1%)had enlarged hilar and mediastinal lymph nodes,which were distributed symmetrically.Extrapulmonary involvements were most commonly presented in extra-thoracic lymph nodes(36 cases,34.95%)and skin(11 cases,10.6%),and they were multiple-organ involvement.LASSO analysis showed that IgA value,lymph node enlargement in group 5 and group 9,and pleural thickening had predictive value for extrapulmonary involvement of sarcoidosis.Conclusion The chest HRCT manifestations of sarcoidosis are typical and have a certain value in predicting whether sarcoidosis is involved outside the lung.Multi-organ involvement is an important feature of sarcoidosis.