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格状影(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.