肺泡蛋白沉积症的64层螺旋CT 影像表现

目的：探讨肺泡蛋白沉积症（pulmonary alveolar proteinosis ，PAP）的64层螺旋CT表现。方法本组患者均行64层螺旋C T扫描，其中7例行肺泡灌洗，1例行C T导引下经皮肺穿刺活检，1例行纤维支气管镜下肺活检，4例经胸腔镜或开胸肺活检均得到病理证实。结果 CT 表现为双肺弥漫性斑片状或片状磨玻璃影，边界清楚呈“地图样”改变，小叶间隔增厚交织呈“铺路石样”改变及实变区“空气支气管征”及模糊结节影。结论 PA P具有特征性的C T表现，即地图样分布、铺路石样改变的磨玻璃影。64层螺旋CT在PAP诊断上有重要临床价值。

64 slice spiral CT imaging manifestations of pulmonary alveolar proteinosis

Objective To retrospectively analyse 64‐layer spiral CT manifestations of pulmonary alveolar proteinsois （pulmonary alveolar proteinsois ,PAP） in order to improve the diagnosis and differential diagnosis of the disease .Methods The 13 patients with pulmonary alveolar proteinosis underwent 64 slice spiral CT scanning ,7 cases were subjected to bronchoalveolar lavage ,1 case to percutaneous lung biopsy with CT induct ,1 case with transbronchial biopsy ,4 cases were confirmed by thoracoscopy or open lung biopsy pathology .Results CT findings included diffused or scattered ground glass‐like images ,clear boundary （“map‐like”） ,interlobular septal thickening and interleaving （cobblestone‐like） ,the area of consolidation“air bronchogram”and Fuzzy nodules .Conclusion HRCT has characteristics of PAP such as geographical patterns ,crazy‐paving sign ,which is more valuable for the diagnosis and prognosis of PAP .The final diagnosis depends on the lung puncture or bronchoalveolar lavage confirmation .