类风湿性关节炎肺间质病变的HRCT诊断价值

目的探讨HRCT对类风湿性关节炎（RA）肺间质病变的诊断价值。方法回顾分析15例类风湿关节炎肺间质病患者的胸部平片、常规CT及HRCT表现。结果15例患者胸部平片主要表现为：肺纹理增粗，肺间质及胸膜改变不明显；常规CT检查表现为：部分肺间质改变及胸膜病变；HRCT均有不同程度的影像学改变，其主要表现为：肺磨玻璃样密度影、蜂窝样囊腔改变及牵引性支气管扩张影、数毫米至1．2cm大小之胸膜下结节。结论磨玻璃样密度影是病变的早期活动性表现，蜂窝样囊腔改变为后期表现，胸膜下结节为其仅有的特异性肺部表现；应用HRCT检查可以明显提高类风湿性关节炎（RA）肺部病变的检出率，了解类风湿性关节炎浸润肺部的程度及估计预后。

Diagnostic Value of HRCT in interstitial lung disease of Rheumatoid Arthritis

Objective To study the manifestation and diagnostic value of HRCT in interstitial lung disease of Rheumatoid Arthritis(RA). Methods Chest x-ray film,CT and HRCT images of 15 cases of RA were retrospectively analyzed. Results Among 15 cases, the most oppearances of chest X-ray wer thest pulmonary markings were in- creased but the changes of pulmonary interstitium and pleura were not obvious. The interstitium and pleura pathological changes could be observed on general CT in some cases. In all cases, the HRCT scans showed pulmonary interstitial changes in different degree,which mainly manifested grount-glass opacity,subpleura granule,honeycomb lung and localized periphery of lung. Conclusion The ground-glass opacity of lung is the feature in ealier period of RA, while the honeycombed lung is the feature in advanced stage and subpleura granule was particular manifestation of RA. HRCT can help to determine the stage of RA and to estimate the prognosis in patients with RA.