64层螺旋CT在肺泡蛋白沉积症诊断中的应用

目的:通过回顾性分析肺泡蛋白沉积症(Pulmonary alveolar proteinosis,PAP)的64层螺旋CT表现,探讨64层螺旋CT快速容扫描(VCT)在肺泡蛋白沉积症诊断中的应用价值,旨在提高对本病的CT诊断水平。方法:本组所有病例均行64层CT快速容积扫描,其中4例行CT导引下经皮肺穿刺活检,8例行肺泡灌洗,4例经纤维支气管镜活检,均得到病理证实。结果:HRCT表现:两肺散在或弥漫性斑片状磨玻璃影、边界清楚("地图样"改变),小叶间隔增厚交织("铺路石样"改变)及实变区"空气支气管征"。结论:肺泡蛋白沉积症的HRCT表现具有相对特征性,充分了解肺泡蛋白沉积症的VCT表现,并做相关疾病的鉴别诊断,能很大程度提高对本病诊断的准确率,最终诊断依靠肺部穿刺或肺泡灌洗后确诊。

Application of 64 Slice spiral CT in the Diagnosis of Pulmonary Alveolar Proteinosis

Objective ：To retrospectively analysis of pulmonary alveolar proteinosis （ Pulmonary alveolar proteinosis, PAP） 64 layer spiral CT manifestations, to explore the application value of 64 slice spiral CT in the diagnosis of pulmonary alveolar proteinosis, aimed at improving the CT diagnostic level of this disease. Methods：The 16 cases of pulmonary alveolar proteinosis patients proeeded 64 layer spiral CT last volume scanning , 4 cases with percutaneous lung biopsy with VCT induct, 8 cases with bronchoalveolar lavage, 4 cases with transbronchial biopsy, are pathology. Results： VCT findings included diffused or scattered ground glass - like images, clear boundary （ ＂map - like＂ change） , interlobular septal thickening and interleaving （ cobblestone - like change） , the area of consolidation ＂air bron-chogram＂. Conclusion ： VCT manifestation of PAP has relative characteristics. Understanding the VCT features of pulmonary alveolar pro- teinosis, it can greatly improve the accuracy of the diagnosis. The final diagnosis depends on the lung puncture or bronchoalveolar lavage confirmed.