胸部结节病的影像学诊断

目的回顾性分析胸部结节病的影像学表现,进一步提高对此病的认识,减少误诊。方法分析36例符合诊断标准的胸部结节病的胸片及CT表现。结果胸部淋巴结增大34例,其中两侧肺门及纵隔淋巴结增大22例,两侧肺门淋巴结增大而无纵隔淋巴结增大2例,一侧肺门及纵隔淋巴结增大7例,一侧肺门淋巴结增大而无纵隔淋巴结增大1例,仅有纵隔淋巴结增大2例。肺部病变25例,其中多发结节18例,条索状影13例,磨玻璃样影11例,支气管血管束增厚5例,空气潴留4例,实变2例。支气管改变8例,胸膜病变3例。CT对纵隔内较小淋巴结及肺内病灶的检出率明显高于胸片。结论有典型影像学表现的胸部结节病诊断容易;不典型者诊断困难,需密切结合临床及治疗后随访。

The Imaging Diagnosis of the Thoracic Sarcoidosis

Objective:To analyze retrospectively the X-ray and CT appearances of the thoracic sarcoidosis,and to obtain a higher accunacy rate,and to reduce misdiagnosis.Methods:X-ray and CT appearances of 36 cases with proven thoracic sarcoidosis were analyzed.Results:In 34 cases enlarged thoracic lymph nodes could be detected.22 of them had bilateral hilar lymph node enlargement and mediastinal lymph node enlargement,2 of them had bilateral hilar lymph node enlargement but no mediastinal lymph node enlargement,7 of them had unilateral hilar and mediastinal lymph node enlargement,and 1 of them had unilateral hilar lymph node enlargement and no mediastinal lymph node enlargement.In 25 cases there were abnonrmal findings in the lungs.18 of them had multiple nodes,13 of them had linear shadows,11 of them had groundglass opacities,5 of them had thickened bronchi and vessels,4 of them had air trapping,and 2 of them had consolidation.Conclusion:Diagnosis of the thoracic sarcoidosis with typical imaging appearances is easy.Diagnosis of the atypical cases is difficult and combination with clinical findings and follow-up is necessary.