肺泡蛋白沉积症的影像学分析

目的 探讨肺泡蛋白沉积症的胸片及CT影像学表现特点，提高诊断率。方法 收集6例经胸片，CT检查，病理活检及肺泡灌洗术证实的病例，结合国内外文献，进行影像分析。结果 胸片和胸部CT均显示两肺弥漫分布的小结节影，两肺散在分布的斑片状或大片状磨玻璃影及实变影。CT还可显示磨玻璃影中的网络状影（碎石路征）和充气支气管征，结论 胸片可发现病变，但不能确诊，CT尤其是高分辨率扫描可清楚显示病变的范围及特征性改变；既边界清楚的地图样分布的磨玻璃影，斑片影及分布其中的网格状影，结合临床可做出诊断。

Analysis of the imaging findings of pulmonary alveolar proteinosis]

OBJECTIVE: To analyze the chest X-ray and CT findings of pulmonary alveolar proteinosis (PAP) in an effort to improve the accuracy of diagnosis. METHODS: The imaging findings by chest X-ray and CT of 6 proven PAP cases (by imaging examinations, autopsy and bronchoalveolar lavage) were retrospectively analyzed on the basis of literature review. RESULTS: Chest X-ray and CT presented diffuse small nodules in both lungs in the 6 cases, also showing scattered small or large patches of ground-glass opacity (GGO) along with consolidation in the lungs. CT also showed reticular shadows (creating typical crazy-paving appearance) and signs of bronchial air in the patches of GGO. CONCLUSIONS: X-ray film can find the pulmonary lesions but is usually unable to establish a definite diagnosis. Chest CT is capable of revealing the extent, delineation and characteristic manifestations of PAP, which helps to derive a definite diagnosis in combination with a thorough review of the patients' clinical history.