亚急性或慢性过敏性肺泡炎的高分辨率CT影像特征

目的：分析亚急性或慢性过敏性肺泡炎高分辨率 CT(HRCT)的影像特征，以期进一步提高其HRCT诊断的准确性。方法：21例亚急性或慢性过敏性肺泡炎患者行肺功能、支气管肺泡灌洗、经支气管镜肺活检、胸部X线平片和HRCT.结果：HRCT图像上16例表现出数量不等的边界模糊的小叶中心结节，13例可见磨玻璃样密度，4例有密度减低区，5例显示局限性的空气残留（airtrapping）并形成“马赛克”样灌注，2例出现散在的小叶中心性气肿、2例发生肺纤维化。结论；HRCT可以清晰显示过敏性肺泡炎病变的类型及分布。HRCT图像上表现为弥漫性边界模糊的小叶中心性结节或小叶中心结节与磨玻璃样祺及密度减低区同时存在时，应考虑亚急性或慢性过敏性肺泡炎的诊断。

Subacute or chronic hypersensitivity pneumonitis : imaging features on high-resolution CT

Objective To identify high resolution CT features of subacute or chronic hypersensitivity pneumonitis ,and to improve HRCT diagnostic accuracy. Methods Twenty one patients with subacute or chronic hypersensitivity pneumonitis were examined with pulmonary function testing,bronchoalveolar lavage,transbronchial lung biopsy,chest radiograph, and HRCT. Results On HRCT, 16 cases had evidence of small,indistinct,and centrilobular nodules, and the profusion of these nodules varied considerably. In 13 cases, areas of ground glass densities were seen. 4 cases had areas of hypolucency. 5 cases had air trapping and mosaic perfusion. 2 cases had centrilobular emphysema . 2 cases had areas of pulmonary fibrosis. Conclusion High resolution CT can clearly show the type and distribution of abnormalities in patients with hypersensitivity pneumonitis. Indistinct centrilobular nodules and areas of ground glass densities,hypolucency together with centrilobular nodules on HRCT should suggest the diagnosis of subacute or chronic hypersensitivity pneumonitis.