百草枯中毒肺损伤的CT表现与临床意义

目的 探讨百草枯中毒患者肺损伤的CT表现及临床价值。方法 回顾性分析6例百草枯中毒患者肺损伤的CT影像学资料,根据中毒时问分早期(1~2 d)、中期(3~14d)、晚期(>14d)3个阶段。对中毒患者进行CT表现与临床表现的对比。结果 6例百草枯中毒患者中3例死亡,2例肺纤维化,1例痊愈。早期CT表现:3例无异常,2例磨玻璃样变,1例肺纹理增多、模糊;中期CT表现:6例磨玻璃样变、马赛克征,6例肺实变,4例胸膜下线,4例出现伴行支气管扩张,2例少量胸腔积液;晚期CT表现:4例肺实变及纤维化,3例磨玻璃样变、马赛克征,1例胸腔积液,1例纵隔气肿。结论 百草枯中毒的临床表现与CT表现基本相符,具有相对分期特征,有助于临床对病情的及时评估,从而指导临床治疗。     

百草枯中毒胸部X线、CT表现 (附21例分析)

目的探讨百草枯中毒的胸部X线和CT表现特征。方法对21例百草枯中毒病人的X线胸片和CT资料进行回顾性分析。结果21例百草枯中毒肺部X线和CT表现随中毒时间变化而不同。≤7d,17例表现为肺纹增多,14例毛玻璃样改变,2例肺实变,肺间质纤维化、胸腔积液、纵隔气肿及心脏增大各1例;7～14d,肺纹理增多、肺实变及肺纤维化各4例,肺毛玻璃样改变3例;≥14d,肺间质纤维化4例,支气管扩张3例,肺纹理增多2例。结论胸部X线平片、CT对观察该病的发展、演变及估计预后、确定治疗方案均有重要意义。     

百草枯中毒胸部X线、CT表现(附17例报告)

目的 :探讨百草枯中毒的肺部X线、CT表现。方法 :对 17例百草枯中毒患者的胸部X线片、CT资料进行回顾性分析。结果 :早期 (≤ 7d)主要表现为肺纹理增多、毛玻璃样改变和肺实变。晚期 (≥ 14d)则以肺间质纤维化和肺小囊性变多见。部分病例可见继发性支气管扩张。结论 :胸部X线平片、CT对观察该病的发展、演变及评价预后 ,确定治疗方案均有重要意义。     

百草枯中毒的肺部CT表现及预后

目的:分析和总结百草枯中毒肺损害的CT表现特点,提高对百草枯中毒肺损害的认识,从而为临床治疗提供有用的价值。方法:回顾性分析41例百草枯中毒肺损害的CT表现,评估其影像学特点。结果:首次检查仅有3例有阳性表现,41例患者于中毒早期(1～7d)死亡8例,余者CT主要表现为仅支气管血管树增多、模糊10例,磨玻璃影18例,实变影4例,胸膜下线11例,肺索条影15例,支气管扩张5例,胸腔积液2例。中毒中期(8～14d)出现4例患者死亡,余者CT主要表现为支气管血管束增粗伴轨道状支气管扩张12例,磨玻璃影13例,肺实变13例,肺索条影9例,气胸1例,胸膜下线8例。中毒后期(>15d),死亡3例,余者CT表现以肺间质改变、肺实变、肺间质纤维化、胸腔积液为主。结论:百草枯中毒的CT表现与临床病理演变有很好的一致性,提高对CT的认识,对临床治疗及预后有很好的帮助。     

百草枯中毒肺损害的X线与CT表现(附14例报告)

目的：提高对百草枯中毒肺损害的X线与CT表现的认识。方法：14例百草枯中毒患者摄胸片，并行CT扫描，随访9例(胸片4例，CT/HRCT 5例)。结果：中毒后第1周：两肺纹理增多、模糊10例，伴两肺散在磨玻璃影3例，两中下肺小斑片状实变2例。第2～3周：显示磨玻璃影5例，实变3例，肺不张1例，其中伴有两侧少量胸腔积液2例、牵引性细支气管扩张1例。第4～5周：肺实变中含有牵引性细支气管扩张2例，局灶性蜂窝1例。第7周：1例CT(含HRCT)显示磨玻璃影与实变影较前缩小，肺纤维化改变明显，并有心脏轻度增大、纵隔气肿等。结论：胸片、CT尤其是HRCT能很好显示百草枯中毒肺纤维化的病理演变过程，有助于判断其临床阶段，帮助决定临床治疗过程。     

百草枯中毒肺损伤MSCT特征与临床预后相关性分析

目的:探讨百草枯中毒肺损害的MSCT表现及临床预后。方法:回顾性分析62例百草枯中毒患者的肺部CT表现及临床资料。结果:百草枯中毒时肺实质、肺间质均可受累。36例出现磨玻璃征和肺实变影,17例显示晚期肺纤维化。62例肺部CT表现与中毒剂量、检查时间相关。结论:百草枯中毒肺部损害具有明确的MSCT影像特征。早、中期以肺实质损害为主要CT表现,晚期以肺间质损害为主要CT表现。MSCT对判断肺损害、评估临床预后及制订治疗方案有重要意义。     

百草枯中毒所致肺部损害的CT分析与预后价值

目的探讨百草枯中毒肺损害CT表现及临床价值。方法对36例百草枯中毒患者CT表现及临床资料进行分析。结果急性期36例中磨玻璃病变者29例,伴有肺实变4例;肺纹理无明显变化者5例。亚急性期26例中肺实变患者14例,新增实变者10例;实变范围扩大者4例。仍有磨玻璃病变者21例,病变范围扩大,1例为新增病例。慢性期16例中磨玻璃样病变及肺实变出现纤维化者有14例。肺损伤程度在小剂量组11例中轻度损伤者8例;中剂量组13例中中度损伤7例;大剂量组12例中重度损伤有6例。结论肺部CT影像表现反映了由肺水肿到肺实变再逐渐到纤维化的病理过程,可对肺损害程度进行判断、评估,对临床预后及制订治疗方案有重要意义。     

百草枯中毒肺损伤的MSCT表现特征与预后相关性分析

目的 探讨百草枯中毒肺损害MSCT表现及临床预后.方法 对百草枯中毒患者的肺部分别进行MSCT检查,并回顾性分析62例患者的CT表现及临床资料.结果 百草枯中毒时肺实质、肺间质均受累,43例出现了磨玻璃征、部分患者肺外周出现肺实变,肺气肿及胸水;晚期肺纤维化是主要特征.62例患者肺部CT表现与中毒剂量、检查时间相关.结论 百草枯中毒肺部损害具有明确MSCT表现特征.早、中期以肺实质损害为主要CT表现,晚期以肺间质损害为主要CT表现.MSCT对判断肺损害、评估临床预后及制订治疗方案有重要意义.     

新生儿支气管肺发育不良的影像学表现(附21例分析)

目的：探讨新生儿支气管肺发育不良的影像学特征，提高对该病的认识。方法：搜集新生儿支气管肺发育不良21例，全部病例均摄胸片，其中18例行螺旋CT扫描，对所有病例的影像学表现进行回顾性分析。结果：21例中，胸片显示两肺野模糊，肺透光度减低．类似肺透明膜样病改变j例，局限性肺气肿4例，弥漫性间质纤维化病变4例。胸片无异常8例。18例CT检查，表现为毛玻璃样病变和实变影5例，多发囊泡状阴影11例，肺间质纤维化改变5例。结论：新生儿支气管肺发育不良的诊断主要根据临床病史及影像学资料。胸片、CT表现虽无特征性，但具有诊断意义，尤其是高分辨率CT能提供更多有价值的征象，有助于本病的诊断。     

甲型H1N1流感病毒肺炎的CT表现

目的：探讨甲型H1N1流感病毒性肺炎CT表现,提高对该病的认识。方法：回顾性分析34例经临床、实验室证实的甲型H1N1肺炎胸部CT表现。结果：34例中累及两肺5个肺叶17例,占50%;累及4个肺叶3例,占8.8%;累及3个肺叶6例,占17.6%;累及2个肺叶5例,占14.7%;累及1个肺叶3例,占8.8%。单纯毛玻璃样阴影15例,占44.1%,表现为斑片状及云雾样淡薄影,边缘模糊,病灶中心密度相对较高,可见血管纹理通过;单纯实变阴影5例,占14.7%,表现为团片状、斑片状及棉球样影,密度较高;毛玻璃影与实变阴影同时存在14例,占41.2%,表现为云雾样淡薄影、棉球样实变影同时存在,肺周边区域及下叶基底部的病灶密度高于其它部位。实变阴影中可见支气管充气征12例,占35.3%;病灶内合并网格样改变19例,占55.9%;小结节影3例,占8.8%;支气管壁增厚3例,占8.8%;两侧胸腔少量积液1例,占2.9%。结论：甲型H1N1肺炎病变分布范围广,变化快,CT表现具有一定特征性。     

Pulmonary CT findings in 320 carriers of human T-lymphotropic virus type 1

PURPOSE: To retrospectively evaluate pulmonary computed tomographic (CT) findings in human T-lymphotropic virus type 1 (HTLV-1) carriers, who were characterized by means of polyclonal integration of proviral DNA. MATERIALS AND METHODS: Institutional review board approval was obtained, and informed consent was waived. Chest CT scans obtained between January 1996 and October 2004 in 320 (154 men, 166 women; age range, 31-86 years; mean, 64 years) patients with HTLV-1 were retrospectively evaluated by three chest radiologists. Parenchymal abnormalities (ground-glass opacity, consolidation, centrilobular nodules, thickening of bronchovascular bundles, interlobular septal thickening, and bronchiectasis) were evaluated, along with enlarged lymph nodes and pleural effusion. In 58 patients who underwent surgical biopsy or transbronchial biopsy, comparison of CT images with the actual specimens was performed by a pathologist and three chest radiologists. RESULTS: On CT scans, abnormal findings were seen in 98 (30.1%) patients and consisted of centrilobular nodules (n = 95), thickening of bronchovascular bundles (n = 55), ground-glass opacity (n = 51), bronchiectasis (n = 50), interlobular septal thickening (n = 28), and consolidation (n = 5). These abnormalities were predominantly seen in the peripheral lung parenchyma (n = 70). Pathologically, these findings corresponded to lymphocytic infiltration along respiratory bronchioles and bronchovascular bundles. Pleural effusion and enlarged lymph nodes were found in two and five patients, respectively. CONCLUSION: CT findings in patients with HTLV-1 consisted mainly of centrilobular nodules, ground-glass opacity, and thickening of the bronchovascular bundles in the peripheral lung. These CT findings are considered suggestive of thoracic involvement in patients with HTLV-1.     

白血病患者骨髓移植术后肺部并发症的CT诊断

目的探讨白血病患者骨髓移植术后肺部并发症的CT诊断。方法对30例白血病患者骨髓移植术后肺部并发症的CT表现进行回顾性分析。结果巨细胞病毒性肺炎可以表现为弥漫性实变、多发结节、毛玻璃改变、多发小片状影,以弥漫性实变为最多见(37.5%,3/8);真菌性肺炎主要表现为单发球形病灶(50.0%,4/8),其中3例病灶周围可见毛玻璃密度影;细菌性肺炎主要表现为单发片状影(50%,1/2);急性呼吸窘迫综合征(ARDS)主要表现为弥漫性实变(66.7%,2/3);肺水肿主要表现为支气管血管束增粗或网格状改变(66.7%,2/3);药物毒性反应可表现为弥漫性实变(50.0%,1/2)或网格状改变(50.0%,1/2);细支气管闭塞并机化性肺炎气管炎(BOOP)表现为多发结节状改变(50.0%,1/2)或毛玻璃密度改变(50.0%,1/2)。移植后3周内发生率最高的为真菌感染,移植后3~14周发生率最高的为巨细胞病毒性肺炎,移植后14周以后病例较少,主要为BOOP。结论综合分析CT表现对血病患者骨髓移植术后肺部并发症的诊断有较高价值。     

结缔组织病肺间质病变的高分辨CT表现及临床意义

目的探讨结缔组织病肺间质病变的高分辨CT表现及临床意义。方法分析26例结缔组织病合并肺间质病变的高分辨CT表现及临床意义。结果26例结缔组织病合并肺间质病变HRCT表现为磨玻璃影、小叶间隔增厚、胸膜下线状影、支气管血管束周围间质增厚、小叶内间质增厚、胸膜下间质增厚、界面征、牵引性支气管扩张、肺小叶变形、蜂窝状影等征象,经糖皮质激素及免疫抑制剂治疗后,部分病例磨玻璃影明显吸收,小叶间隔增厚、支气管血管束周围间质增厚、小叶内闻质增厚有所减轻,但蜂窝状影、牵引性支气管扩张、肺小叶变形无改变。结论磨玻璃影、小叶间隔增厚、胸膜下线状影、支气管血管束周围间质增厚、小叶内间质增厚、胸膜下间质增厚、以及界面征等征象可能为可逆改变,而牵引性支气管扩张、肺小叶变形、蜂窝状影为不可逆改变。结缔组织病合并肺间质改变的高分辨cT表现对早期诊断及临床治疗有重要意义。     

痰涂片阴性活动性肺结核的CT诊断

目的探讨CT对痰涂片阴性活动性肺结核的诊断价值及影像学特点。方法回顾性分析临床证实的116例痰涂阴性活动性肺结核的临床及CT扫描资料。结果CT扫描证实116例中,病变累及双侧肺44例（37．93％）;病变累及单侧肺72例（62．07％）,病变累及单个肺叶61例（52．60％）,小叶中心结节影（含树芽征）97例（83．60％）,毛玻璃密度影95例（81．90％）,支气管管壁增厚72例（62．00％）,段及亚段肺实变和小叶样实变17例（14．70％）,空洞21例（18．10％）。结论CT通过对特征性影像的检出在涂阴活动性肺结核的诊断中有重要价值。     

Chlamydia pneumoniae: comparison with findings of Mycoplasma pneumoniae and Streptococcus pneumoniae at thin-section CT

PURPOSE: To retrospectively compare thin-section computed tomographic (CT) findings of Chlamydia pneumoniae pneumonia with those of Streptococcus pneumoniae pneumonia and Mycoplasma pneumoniae pneumonia. MATERIALS AND METHODS: Institutional review board and patient informed consent were not required. Twenty-four patients with C pneumoniae pneumonia (17 men, seven women; age range, 19-89 years) underwent thin-section CT; 41 patients with S pneumoniae pneumonia (28 men, 13 women; age range, 19-91 years) and 30 patients with M pneumoniae pneumonia (20 men, 10 women; age range, 16-67 years) were also enrolled. Thin-section CT scans of each patient were retrospectively and independently assessed by two chest radiologists for consolidation, ground-glass opacity (GGO), bronchovascular bundle thickening, nodules, pleural effusion, lymphadenopathy, reticular or linear opacity, airway dilatation, pulmonary emphysema, and bilateral lung involvement. Consensus was reached for disagreements. The frequency of each finding was compared among the three types of pneumonia by using the chi2 test. RESULTS: For C pneumoniae pneumonia, CT demonstrated consolidation in 20 patients, GGO in 13, bronchovascular bundle thickening in 17, nodules in 18, pleural effusion in six, lymphadenopathy in eight, reticular or linear opacity in 15, airway dilatation in nine, pulmonary emphysema in 11, and bilateral lung involvement in 12. Bronchovascular bundle thickening (P = .022) and airway dilatation (P = .034) were significantly more frequent in patients with C pneumoniae pneumonia than in those with S pneumoniae pneumonia. Reticular or linear opacity (P = .017), airway dilatation (P = .016), and associated pulmonary emphysema (P = .003) were significantly more frequent in patients with C pneumoniae pneumonia than in those with M pneumoniae pneumonia. CONCLUSION: C pneumoniae pneumonia demonstrates a wide spectrum of thin-section CT findings that are similar to those of S pneumoniae pneumonia and M pneumoniae pneumonia; airway dilatation and bronchovascular thickening were significantly more frequent in patients with C pneumoniae pneumonia.     

Idiopathic interstitial pneumonias: CT features

Idiopathic interstitial pneumonias comprise usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), desquamative interstitial pneumonia (DIP), respiratory bronchiolitis-associated interstitial lung disease (RB-ILD), cryptogenic organizing pneumonia (COP), acute interstitial pneumonia (AIP), and lymphoid interstitial pneumonia (LIP). Each of these entities has a typical imaging and histologic pattern, although in practice the imaging patterns may be variable. Each entity may be idiopathic or may be secondary to a recognizable cause such as collagen vascular disease or inhalational exposure. The diagnosis of idiopathic interstitial pneumonia is made by means of correlation of clinical, imaging, and pathologic features. The characteristic computed tomographic (CT) features of UIP are predominantly basal and peripheral reticular pattern with honeycombing and traction bronchiectasis. NSIP is characterized by predominantly basal ground-glass opacity and/or reticular pattern, often with traction bronchiectasis. DIP and RB-ILD are smoking-related lung diseases characterized by ground-glass opacity and centrilobular nodules. COP is characterized by patchy peripheral or peribronchovascular consolidation. AIP manifests as diffuse lung consolidation and ground-glass opacity. LIP is associated with a CT pattern of ground-glass opacity sometimes associated with perivascular cysts.     

肺非结核分支杆菌病的CT征象分析

目的 探讨肺非结核分支杆菌病CT表现.资料与方法 回顾性分析70例确诊的肺非结核分支杆菌病CT表现.结果 CT表现结节63例,斑片、片样实变68例,空洞56例,薄壁空洞48例, 支气管扩张62例,树芽征25例,磨玻璃影6例,线状及纤维条索影22例.结论 肺非结核分支杆菌病CT表现与结核类似,需结合其它表现进行诊断.     

系统性红斑狼疮胸部CT短期随访研究(附64例分析)

目的:探讨系统性红斑狼疮(SLE)患者胸部CT征象的病变性质、病理基础。方法:回顾性分析64例SLE患者203次胸部CT检查[139次CT复查,每例行1～4次,平均(91.57±68.57)d复查1次]图像,计算各种病变CT征象的显示率,对各种病变的CT征象进行程度、范围积分,并作统计学对比处理。结果:在CT短期随访复查后发现胸部常见CT征象中肺实变(18例)、磨玻璃样影(57例)明显容易发生变化(好转或加重),其变化频率显著高于小叶间隔增厚(51例)、界面征(38例)、胸膜下线征(13例)、胸膜肥厚(34例)、心包肥厚(16例,P均<0.001),前两者、后五者之间差异均无统计学意义(P均>0.05)。此外,肺内蜂窝样改变(3例)、单个或多发肺囊肿样改变(8例)、胸膜腔积液和腹水(各3例)、纵隔和/(或)两腋下显示多发大小不等淋巴结(24例)在CT复查中无明显变化。SLE肺部磨玻璃样影、小叶间隔增厚、界面征病变的程度、范围差异无统计学意义(P均>0.05),但显著大于肺实变、胸膜下线征、胸膜肥厚和心包肥厚(P均<0.05);心包肥厚病变的程度、范围与肺实变相仿(P>0.05),但显著小于其他常见病变(P均<0.001)。磨玻璃样影的CT复查病变程度、范围变化显著大于肺实变及因病例数较少未纳入统计处理者以外的其他病变(P均<0.05)。结论:SLE患者胸部CT征象短期随访复查可以一定程度上反映其病理基础,有助于临床病情、疗效的判断。