肺韦格肉芽肿的CT特征分析

目的：探讨肺部韦格肉芽肿的ＣＴ表现特点和鉴别诊断价值。方法：对10例经肺穿刺活检和临床综合资料证实的韦格肉芽肿病人的肺部CT表现进行回顾性分析。结果：6例表现为肺内多发性结节和空洞。2例见肿块，所有肿块均出现空洞。2例可见基底贴附于胸膜面的楔形阴影，楔形阴影内密度不均，5例显示供养血管征。4例毛玻璃样改变和实变。4例支气管管壁增厚，1例见气管狭窄。3例支气管扩张。胸膜粘连和胸腔积液各1例。结论：肺内多发性肺结节伴空洞、楔形灶、毛玻璃样改变和实变对肺韦格肉芽肿具有相对特异性，“供养血管征”是本病重要特征之一。而这些病灶的特殊变化规律更具诊断价值。

CT manifestations analysis of Wegener granulomatosis in lung

Objective: To evaluate CT manifestations and the value of diagnosis of Wegener granulomatosis of lung. Methods: All the CT findings of the 10 cases with Wegener granulomatosis in lung confirmed clinically or by operation were analyzed retrospectively. Results: Nodules and cavitations were seen in 6 patients. Masses with cavitations were seen in 2 patients. Wedge-shaped areas of peripheral consolidation without uniform density abutting the pleura were seen in 2 patients. A feeding vessel sign to a nodule or mass were seen in 5 patients. Ground-glass attenuation and consolidation were seen in 4 patients. Bronchial wall thickening was discovered in 4 patients,tracheostenosis was seen in 1 patient,bronchiectases were found in 3 patients. Pleural irregularities were seen in 1 patient and pleural effusion was seen in 1 patient. Conclusion: Nodules and cavitations,wedge-shaped areas of peripheral consolidation,ground-glass attenuation and consolidation in lung are specific signs in diagnosing Wegener granulomatosis in lung. A feeding vessel sign to a nodule or mass is also one of its important characteristics,and all these special developments are more important for us to diagnose Wegener granulomatosis in lung.