原发性气管支气管淀粉样变的MSCT诊断

目的：探讨原发性气管支气管淀粉样变的 MSCT 表现。方法：搜集本院经病理证实的5例原发性气管支气管淀粉样变性的影像资料，对病变气管支气管壁厚度、密度、管腔形态及病变范围进行回顾性分析。结果：弥漫型4例，受累气管支气管壁环形增厚，呈连续性分布，管壁厚度3～6mm，其中气管至3级支气管2例，气管至4级支气管2例。2例气道壁呈片状及环状钙化，以支气管明显，2例为局灶性小钙化。局限型1例，表现为右侧中间段支气管管壁增厚，管腔狭窄，气道壁未见明显钙化，患侧肺门淋巴结肿大并伴有蛋壳样钙化。气道内膜凹凸不平4例，1例尚光滑。5例管腔均出现不同程度狭窄，1例2级支气管闭塞伴肺不张，1例气管至2级支气管狭窄，3～5级支气管管腔相对扩大，继发感染。结论：原发性气管支气管淀粉样变性 MSCT 主要表现为气道壁结节样增厚，局灶性或弥漫性分布，伴或不伴有钙化，气管壁后部可以受累。

MSCT diagnosis of primary tracheobronchial amyloidosis

Objective:To investigate the manifestations of primary tracheobronchial amyloidosis with MSCT.Meth-ods:Imaging materials of five patients with primary tracheobronchial amyloidosis confirmed by pathology in our hospital were collected,the wall thickness,density,lumen morphology,extent of tracheobronchial lesion were retrospectively ana-lyzed.Results:Of the 5 cases,4 were diffuse type,the tracheobronchial wall were annularly thickened with continuous distri-bution with the thickness as 3~6mm.The lesion involved trachea to level 3 bronchi in 2 cases,the other 2 cases were from trachea to level 4 bronchi.Plague like and annular calcification of airway wall were shown in 2 cases,the other 2 cases had small foci of calcification.There was one case with limited type,showing as thickening and lumen stenosis of the right inter-mediate bronchus without obvious calcification,enlarged lymph nodes of the affected side of pulmonary hilum accompanied with"egg shell"calcification could be revealed.Of the 5 cases,inner mucous membrane lining of airway were uneven in 4 ca-ses,and smooth in one case.Different degrees of airway stenosis were showed in all 5 cases,one case had level-2 bronchial occlusion and pulmonary atelectasis,one case had trachea to level 2 bronchial stenosis,with relative enlargement of level 3~5 bronchi and secondary infection.Conclusion:The main MSCT manifestations of primary tracheobronchial amyloidosis were nodular thickening of airway wall,focal or diffuse distribution,with or without calcification,the posterior tracheal wall might be involved.