特发性肺纤维化的高分辨率CT评价

目的 评价高分辨率CT（HRCT）对特发性肺纤维化（IPF）的诊断及鉴别诊断的价值，探讨病程与HRCT表现之间的关系。材料与方法 经临床及病理证实的29例IPF患者常规CT检查后对兴趣区行HRCT扫描，观察病变的分布及HRCT表现，并按病程在1年以下、1－2年、2－3年及3年以上分为4组，分析病程与HRCT表现之间的关系。结果 IPF的主要HRCT表现：（1）磨玻璃样密度影；（2）肺小叶间隔增厚；（3）小叶内间质增厚；（4）小叶结构变形；（5）蜂窝肺；（6）交界面不规则；（7）胸膜增厚。小叶间隔增厚及小叶内间质增厚。病程在2年以上分别占72％（21／29）及86％（12／14）。蜂窝肺病程在3年以上占60％（12／20）。病变呈周围型分布。结论 HRCT能细致、准确地反映IPF的大体病理变化，但各种征象均可见于其他各种间质性疾病，小叶间隔增厚及小叶间质增厚伴有肺结构变形和病变的周围型分布对诊断和鉴别诊断较有意义。诊断须结合临床并除外其他原因引起的肺纤维化。

High Resolution CT Evaluation of Idiopathic Pulmonary Fibrosis

Objective To evaluate high resolution CT (HRCT) in the diagnosis and differentiation of idiopathic pulmonary fibrosis (IPF).Materials and Methods HRCT of the region of interest was performed in 29 cases with clinically and pathologically proved IPF after routine CT scanning. The distribution of the lesions and findings on HRCT were observed. Results The main findings were as follows: (1) ground glass opacity; (2) thickened pulmonary lobular septa; (3) thickened lobular interstitium; (4) distorted lobular structures; (5) honeycomb; (6) irregularity of the interfaces.Conclusion HRCT is the first choice for the diagnosis of IPF, and HRCT findings are related to the stage of the disease.