CT诊断支气管扩张评价（附反复间断咯血41例分析）

ＣＴ诊断支气管扩张评价（附反复间断咯血４１例分析）张先钊支气管扩张（以下简称支扩）是呼吸系统常见病、多发病。临床常常依靠Ｘ线帮助确诊。支扩临床主要表现是反复间断咯血。以中青年多见。受凉后出现症状。胸部Ｘ线片诊断支扩较困难，必须作支气管造影才能明确诊断...     

支气管扩张症的CT诊断（附40例分析）

目的：通过分析４０例支扩的ＣＴ表现，探讨结合ＨＲ ＣＴ对支护的诊断优越性。材料和方法：临床或胸片怀疑，ＣＴ证实的支扩４０例，采用３型分法即柱状型，静脉曲张型，囊状型，分析各型的分布，ＣＴ表现和病变关系，ＣＴ扫描方法对诊断的影响。结果：４０例患者各肺叶都有，以柱状最多见，各型表现各有特点，都常伴结核，感染等。结论：ＨＲ ＣＴ扫描完全能代替支气管造影诊断支扩。     

CT检查支气管扩张的价值如何

ＣＴ检查支气管扩张的价值如何虽然ＣＴ检查支扩还不如支气管造影具有决定性意义，但对平片疑有支扩者，ＣＴ检查仍有较大价值。ＣＴ扫描中以下征象可作为诊断支扩的参考标准：１支气管壁增厚并伸向肺野的边缘（因大多数支扩伴有支气管壁的增厚）；２ＣＴ扫描平面与支气管...     

支气管扩张症CT诊断要点

由于支气管扩张的CT表现有高度的特异性以及CT的分辨率提高能够准确的显示病变范围，CT扫描诊断支气管扩张症因其无痛苦、无刺激的检查特点，所以基本取代了支气管造影对支扩的诊断。现将支气管扩张症的CT诊断要点总结如下：     

HRCT对支气管扩张的诊断

目的：评价HRCT对支气管扩张诊断的可靠性。方法：对经胸外手术或呼吸科随访观察确诊支气管扩张症的26例病例，并均采用了HRCT检查的患者进行回顾性分析，结果：26例患者中HRCT诊断支气管扩张症26例75个肺段，其中柱状型10例，静脉曲张型5例，囊状型2例和混合型9例，结论：HRCT对支气管扩张的检测具有高度的敏感性和特异性，不仅显示支气管扩张范围、程度和部位，而且无创伤，在诊断方面可以取代较痛苦的传统支气管造影。     

X线平片,CT,HRCT和3DCT诊断支气管扩张

本文收集我院１９９２０４～１９９８０３，２７例支气管扩张患者的Ｘ线平片、常规ＣＴ、ＨＲＣＴ及３ＤＣＴ影像资料进行分析，探讨其影像学表现及其诊断价值。１　材料和方法２７例支气管扩张，１１例经手术及病理证实，１５例典型症状及治疗证实，１例经支气管造影证实。男１４例，女１３例，年龄２９～７８岁，平均４３－１岁。病程３天～２０年。临床症状咯血８例，反复咳嗽并咯血１５例，一次咯血量３０～１０００ｍｌ。反复咳嗽并发热４例。２７例均有胸正侧位片。２１例胸部常规ＣＴ增强扫描，层厚８ｍｍ，层间距１０ｍｍ，使用…     

支气管扩张症的X线平片、CT和HRCT对照分析

目的：对支气管扩张的Ｘ线平片、ＣＴ和ＨＲＣＴ表现做一对比分析。方法：取病理证实支扩２０例，分别摄有胸正侧位片，常规ＣＴ扫描和ＨＲＣＴ扫描。ＨＲＣＴ选薄层，大矩阵和高分辨率算法。结果：显示Ｘ光平片漏诊率高（８／２０），特异性低（３／２０）。ＣＴ较平片显示肺“盲区”效果好，有粘液嵌塞者，常规ＣＴ像上有时不易与血管性病变鉴别，ＨＲＣＴ可显示部分含气的支气管腔存在。结论：ＨＲＣＴ扫描诊断支扩特异性高，可与支气管造影相媲美，它不仅显示支扩范围、程度和部位，还能显示小叶中央性改变。常规ＣＴ较平片显示率高。     

支气管扩张的HRCT诊断

支气管扩张的诊断,以往要根据典型临床症状、X线平片所见和支气管碘油造影检查确诊,但由于支气管造影是一种侵入性方法,病人痛苦、有一定危险性,在临床上已逐渐被淘汰.CT扫描作为一种无痛、无创伤的影像学检查方法,已日益受到重视.HRCT诊断支气管扩张,基本上可以完全替代支气管造影.有关HRCT诊断支气管扩张的报道较少,本文对15例经病理证实或经临床随访确诊的支气管扩张患者的HRCT表现进行回顾性分析,并就有关问题进行讨论.     

胸部高分辨CT检查技术的临床应用

笔者对５０例肺部疾病胸部常规ＣＴ和高分辨率ＣＴ（ＨＲＣＴ）图像进行了对照分析。其中特发性肺间质纤维化（ＩＦＰ）８例，肺转移癌５例，支气管扩张１５例，周围型肺癌７例。结果表明：ＨＲＣＴ在ＩＦＰ、支气管扩张和肺气肿的显示明显优于常规ＣＴ（Ｐ〈０．００１），在对肺部发或转移性肿瘤的显示能提供更多的诊断信息。笔者还讨论了ＨＲＣＴ的检查技术和图像后处理，分析了影响ＨＲＣＴ的若干因素，指出通过缩小视野（ＦＯＶ     

华支睾吸虫病肝内胆管扩张的CT特征及其鉴别诊断

分析４２例华支睾吸虫病肝内胆管扩张的ＣＴ表现，并与４０例良、恶性阻塞性黄疸病例的ＣＴ表现进行比较，结果显示肝内胆管轻度弥漫型扩张为其主要ＣＴ表现。末梢囊状型扩张虽仅占１９％，但却是本病可靠且特异的ＣＴ征象。同时就四种肝内胆管扩张类型的机理、临床意义和本病的鉴别诊断进行了分析及探讨。     

Computed tomography of bronchiectasis in association with tuberculosis

Eight patients with pulmonary tuberculosis proven by positive sputum culture were found to have various degrees of bronchiectasis by computed tomography (CT) but not by plain chest radiography. The CT is characterized by cystic dilatation of the thick-walled bronchi manifested as strings or clusters of pearls or grapes for cystic bronchiectasis and a "tram-line" appearance for cylindrical bronchiectasis. We stress that bronchiectasis remains quite common in association with pulmonary tuberculosis, and CT can replace bronchography for its detection.     

High attenuation mucous plugs in allergic bronchopulmonary aspergillosis: CT appearance.

Allergic bronchopulmonary aspergillosis is an immunologic disease characterized by bronchiectasis and recurrent mucous plugging in asthmatics. The usual CT appearance is that of low attenuation branching structures corresponding to impacted dilated bronchi. We report a patient with allergic bronchopulmonary aspergillosis and mucous plugging manifested by high attenuation structures on CT. A follow-up examination demonstrated resolution of the mucous secretions and residual bronchiectasis. Possible etiologies for this CT appearance are discussed.     

How useful is computed tomography in the diagnosis and assessment of bronchiectasis?

A study was performed to determine the value of computed tomography (CT) in the diagnosis and assessment of cylindrical and mild varicose bronchiectasis. Fifteen patients, in whom bronchography had shown such bronchiectasis in 34 of 73 lobes that could be assessed, were examined by CT. A control group of 12 subjects in whom there was no clinical or plain radiographic suspicion of bronchiectasis was also studied. Computed tomography (CT) was considered to show bronchiectasis in 28 lobes, 27 of which were bronchiectatic as shown by bronchography. Of 45 lobes where CT was not thought to show bronchiectasis, bronchography demonstrated 38 normal and seven bronchiectatic lobes. All lobes in the control group were interpreted as normal. Using bronchography as the definitive investigation for cylindrical or mild varicose bronchiectasis, CT has a sensitivity of 79% and a specificity of 99% in the diagnosis of the disease. The high specificity indicates that a diagnosis of cylindrical or mild varicose bronchiectasis by CT is reliable but CT is too insensitive to be used as a screening test.     

Hypothesis on the evolution of cavitary lesions in nontuberculous mycobacterial pulmonary infection: thin-section CT and histopathologic correlation

OBJECTIVE: The objectives of our study were to evaluate the thin-section CT findings of the cavitary form of nontuberculous mycobacterial pulmonary infection and correlate these imaging findings with the histopathologic findings concerning the development of bronchiectasis and of centrilobular nodules and cavitary lesions. MATERIALS AND METHODS: We retrospectively reviewed thin-section CT scans (2.5-mm collimation, both axial and coronal reformation images) of 24 cases (male-female ratio, 13:11; mean age, 61 years; age range, 43-82 years) of the cavitary form of culture-proven Mycobacterium avium-intracellulare complex pulmonary infection including two cases with lobectomy specimens. Any changes in CT findings detected on the follow-up CT scans that were available for seven patients (follow-up interval, 6-24 months; mean, 12 months) were also assessed. RESULTS: Thin-section CT findings were bronchiectasis (24/24 patients, 100%), a patent bronchus running into a cavitary lesion (the "feeding bronchus" appearance) (18/24, 75%), nodules less than 10 mm (17/24, 71%), centrilobular nodules (17/24, 71%), nodules of 10-30 mm (13/24, 54%), peribronchial nodules (8/24, 33%), lobular consolidation (6/24, 25%), bronchial wall thickening (4/24, 17%), and consolidation (2/24, 8%). Two lobectomy specimens showed large cavitary consolidations with the feeding bronchus appearance on pathologic specimens. In two patients, small peribronchial nodules had changed into cavitary nodules with the feeding bronchus appearance on follow-up CT, which represented inflamed focal cystic bronchiectasis. CONCLUSION: In the cavitary form of M. avium-intracellulare complex pulmonary infection, the feeding bronchus appearance is another very frequent thin-section CT finding. This appearance may suggest that peribronchial nodules of M. avium-intracellulare complex infection evolve into inflamed focal cystic bronchiectasis manifesting as cavitary lesions.     

CT及多层螺旋CT诊断支气管扩张的临床意义

目的：探讨CT及多层螺旋CT在支气管扩张症诊断中的意义。方法选取2005年～2013年我院治疗的支气管扩张症患者86例,随机分成两组,观察组（43例）通过CT及多层螺旋CT诊断,对照组（43例）通过X线平片诊断,对比其诊断结果。结果在支气管扩张类型（肺段数）上观察组显然高于对照组,差异有统计学意义（ P＜0.05）。结论和X线平片检查相比多层螺旋CT和CT在对支气管扩张进行诊断的过程中,有着更加明显的优势,而且有着比较高的特异性,可以将支气管扩张的程度、位置、小叶中央型变化及范围皆有较显著的展现,其诊断效果更准确。     

Congenital bronchiectasis due to cartilage deficiency: CT demonstration

The CT appearance of bronchiectasis on inspiration and expiration in a patient with congenital bronchiectasis due to cartilage deficiency (Williams-Campbell syndrome) is reported. Computed tomography demonstrated characteristic findings of this syndrome, ballooning of bronchi on inspiration and collapse on expiration.     

Low-dose, volumetric helical CT: image quality, radiation dose, and usefulness for evaluation of bronchiectasis

RATIONALE AND OBJECTIVES: The aim of our study was to assess the image quality, radiation dose, and clinical applicability of low-dose, volumetric helical CT in the evaluation of bronchiectasis. METHODS: Volumetric helical CT scans (120 kVp, 3-mm collimation, pitch of 2, and reconstruction interval of 2 mm) were obtained through the thorax at four levels of tube current: 150, 100, 70, and 40 mA. There were a total of 12 patients who underwent CT scan either for suspected bronchiectasis or for lung cancer screening, with three patients allocated to each current level. Five radiologists assessed and compared image quality of the helical CT scans obtained at the various exposure levels. Radiation doses of helical CT performed with four different current settings and of high-resolution CT (120 kVp, 170 mA, 1-mm collimation, and 10-mm intervals) were measured. The diagnostic usefulness of the 40-mA helical CT images was compared with that of high-resolution CT by two observers in 52 patients with known or suspected airway diseases. RESULTS: With helical CT, there was no significant difference in image quality among the four different levels of current (P > 0.05). Radiation doses associated with the 40-, 70-, 100-, and 150-mA helical techniques were 3.21 mGy (range, 3.02-3.57), 4.81 mGy (range, 3.89-5.93), 6.46 mGy (range, 6.01-7.31), and 10.4 mGy (range, 8.93-12.1), respectively, whereas that of high-resolution CT was 2.17 mGy (range, 1.90-2.67). Of 52 patients, 44.5 and 47 patients (the mean of positive interpretations by the five observers) were diagnosed with bronchiectasis at high-resolution and low-dose helical CT, respectively. Of 928 segments, bronchiectasis was seen in 152.5 segments on high-resolution CT and in 193.5 segments on helical CT. The interobserver agreement (k-values) was acceptable for both techniques. CONCLUSIONS: With acceptable images and similar radiation dose, low-dose volumetric helical CT at 40 mA may offer more information than does high-resolution CT in the evaluation of bronchiectasis.     

支气管扩张症的CT诊断分型及临床价值探讨

目的:(1)分析影响CT对支气管扩张检出的重要因素;(2)探讨具有指导临床治疗意义的支气管扩张的CT分型方法。材料和方法:对58例患者行常规CT扫描,选择其中22例行靶区高分辨扫描。所有病例均经临床证实。结果:(1)经CT共检出54例支气管扩张症,其敏感性为93％,2例假阴性,2例误诊;(2)找出了易漏误诊的支气管扩张CT征象;(3)在传统的支气管扩张CT分型的基础上,首次提出并定义了蜂窝型,从而使支气管扩张CT分型发展为4型。结论:在常规胸部CT扫描基础上合理使用薄层高分辨CT扫描可提高支气管扩张的检出率,支气管扩张的CT分型为临床计划的实施提供了重要的依据。     

Value of medium-thickness CT in the diagnosis of bronchiectasis

The usefulness of CT with 4-mm-thickness cuts at 5-mm intervals in the diagnosis of bronchiectasis was studied by comparing the results of CT with those of bronchography in 323 segmental bronchi in 20 patients. No bronchiectasis was found on either study in 222 segmental bronchi. Of the 101 segmental bronchi showing bronchiectasis on bronchography, CT correctly identified bronchiectasis in 98 segments (97%). Bronchography showed cystic bronchiectasis in 35 and varicose bronchiectasis in 14 segmental bronchi, all of which were correctly identified on CT. Of the 52 segmental bronchi showing cylindrical bronchiectasis on bronchography, CT correctly identified these changes in 49 segments but failed to detect it in three. The presence of interstitial lung disease with emphysema and very localized mild bronchiectasis in one case each made the identification of cylindrical bronchiectasis difficult and caused the false-negative results. When bronchography is used as the criterion, CT with medium-thickness cuts and medium slice intervals appears to be 100% specific for all types of bronchiectasis, 100% sensitive for cystic and varicose bronchiectasis, and 94% sensitive for cylindrical bronchiectasis.     

Bronchiectasis: assessment by thin-section CT

To assess the accuracy of computed tomography (CT) in the evaluation of bronchiectasis, we performed thin-section CT in 36 patients with clinical findings suggestive of this diagnosis. CT was performed with 1.5-mm section thickness and 10-mm intersection spacing. Bilateral (eight patients) and unilateral (28 patients) bronchograms were obtained. CT and bronchographic findings were correlated in 44 lungs. In 15 lungs no bronchiectasis was observed on CT scans and bronchograms. In 25 lungs both examinations accurately indicated the presence and extent of bronchiectasis. In two lungs the extent of disease was underestimated on CT, which failed to indicate bronchiectasis in one segment of the affected lobe. In one case CT findings suggested focal bronchial disease, but the lung was misinterpreted as not bronchiectatic; the bronchogram showed cylindric bronchiectasis. In one case CT disclosed cylindric bronchiectasis in a lobe that was bronchographically normal, but in this case the bronchogram was probably misinterpreted as false negative. In two cases lung findings were better visualized on CT scans than on bronchograms. It is concluded that thin-section CT is an accurate procedure in the recognition of bronchiectasis.