外源性过敏性肺泡炎高分辨率CT特点及其诊断价值

目的 探讨外源性过敏性肺泡炎(EAA)的高分辨率CT(HRCT)特征及其诊断价值.方法 回顾性分析2001年2月至2009年8月在首都医科大学附属北京朝阳医院确诊的34例EAA患者的胸部HRCT影像学表现及相关临床资料.结果 34例患者均有明确的环境抗原暴露史,间歇或持续抗原暴露时间为3个月～13年.临床表现2例呈急性,22例呈亚急性,10例呈慢性.2例急性EAA胸部HRCT分别表现弥漫磨玻璃影和磨玻璃影伴马赛克征;亚急性者主要表现弥漫分布的斑片磨玻璃影伴马赛克征(11例,50.0%)、弥漫分布的小叶中心结节(7例,31.8%)和马赛克征(4例,18.2%);慢性者均表现网格影或伴蜂窝肺,其中3例伴斑片磨玻璃影,3例伴马赛克征,3例伴小叶中心结节.结论 EAA的胸部HRCT有比较特征性的表现,对EAA的诊断和鉴别诊断具有重要的提示作用.

Chest high resolution CT features of extrinsic allergic alveolitis and its diagnostic value

Objective To summarize the chest high-resolution CT(HRCT) features of the patients with extrinsic allergic alveolitis (EAA). Methods We analyzed the images of chest HRCT of 34 patients diagnosed as EAA at our hospital from February 2001 to August 2009. Results All patients had a history of environmental exposure. The duration of intermittent or continuous antigen exposure was from 3 months to 13 years. Two patients showed acute clinical manifestations. There were 22 sub-acute and 10 chronic cases.Acute EAA was characterized by ground-glass opacities, air trapping and/or mosaic sign on HRCT. The HRCT features of subacute EAA included patchy ground-glass opacities with mosaic sign (n =11, 50. 0% )and diffusely distributed centrilobular nodules ( n = 7, 31.8% ) with mosaic sign ( n = 4, 18. 2% ). All patients with chronic EAA had reticular and honeycombing lesions on HRCT. There were 3 cases with ground-glass opacities, 3 with mosaic sign, and 3 with centrilobular nodules. Conclusion The typical findings of chest HRCT are helpful for making a diagnosis and differential diagnosis of EAA.