肺泡蛋白沉积症影像学诊断分析

目的 分析并探讨肺泡蛋白沉积症的影像学诊断方法.方法 回顾性分析本院收治的7例肺泡蛋白沉积症患者的影像学资料,并与国内外相关报道进行比较以探讨该病的病理学基础.结果 5例患者胸片显示病变部位位于两肺中下野,呈现出分散的颗粒状的小结节,边界不清.2例患者于1年后其右下肺开始融合成片,1例患者左下肺出现融合,2 例患者两肺均有弥漫性片状影.5例为中心型,肺内病变部位呈现出羽毛状浸润阴影或弥漫状模糊的小结节.2例为外围型,其小叶模糊浸润阴影主要位于两肺的外周,但外周和中心阴影呈交替出现.无纵隔淋巴结、肺门肿大以及心影增大病例.结论 认真分析X线征象,确定肺部病变为腺泡型,再参考病灶形态及分布,肺内外是否有其他变化,影像动态比较分析以及临床病史进行综合判定,在无纤维支气管镜检查与病理检查的情况下也能对肺泡蛋白沉积症明确诊断.

Imaging diagnosis analysis of pulmonary alveolar proteinosis

Objective To analyze and explore the imaging diagnostic method of pulmonary alveolar proteinosis.Methods The imaging data of 7 patients with pulmonary alveolar proteinosis were analyzed and compared with the domestic and foreign relevant reports to explore the pathological basis of the disease.Results In 5 patients with chest radiography showed the lesion site located two lungs out,showing a dispersed granular nodules,unclear boundaries.In 2 patients 1 years after the right lower pulmonary fusion piece,1 patients left lower lung merging,in 2 patients with two lung had a diffuse patchy shadow.In 5 patients as the center,intrapulmonary lesions showing a feathery infiltrative shadows or diffuse fuzzy nodules.2 cases of peripheral type,its invasive lobular fuzzy shadows are mainly located in two of the peripheral pulmonary,but peripheral and central shadow was alternately.In all cases of mediastinal lymph nodes in lung door enlargement,and enlarged heart shadow.Conclusion Careful analysis of X-ray findings,determine lung acinar type,reference to lesion morphology and distribution,pulmonary and whether there are other changes,image dynamic comparative analysis and comprehensive judgment in the clinical history,in the absence of fiber branch microscopic examination and pathological examination of the circumstances can clear diagnosis.